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Abstract：
BACKGROUND: Patients with idiopathic scoliosis commonly present with an imbalance of the paraspinal muscles. However, it is unclear whether this muscle imbalance is an underlying cause or a result of idiopathic scoliosis. This study aimed to investigate the role of paraspinal muscles in the development of idiopathic scoliosis based on surface electromyography (sEMG) and radiographic analyses.
METHODS: This was a single-center prospective study of 27 patients with single-curve idiopathic scoliosis. Posteroanterior whole-spine radiographs and sEMG activity of the erector spinae muscles were obtained for all patients in the habitual standing position (HSP), relaxed prone position (RPP), and prone extension position (PEP). The Cobb angle, symmetrical index (SI) of the sEMG activity (convex/concave), and correlation between the two factors were analyzed.
RESULTS: In the total cohort, the mean Cobb angle in the HSP was significantly greater than the mean Cobb angle in the RPP (RPP-Cobb) (p < 0.001), whereas the mean Cobb angle in the PEP (PEP-Cobb) did not differ from the RPP-Cobb. Thirteen patients had a PEP-Cobb that was significantly smaller than their RPP-Cobb (p = 0.007), while 14 patients had a PEP-Cobb that was significantly larger than their RPP-Cobb (p < 0.001). In the total cohort and two subgroups, the SI of sEMG activity at the apex vertebra (AVSI) in the PEP was significantly greater than 1, revealing significant asymmetry, and was also significantly larger than the AVSI in the RPP. In the RPP, the AVSI was close to 1 in the total cohort and two subgroups, revealing no significant asymmetry.
CONCLUSIONS: The coronal Cobb angle and the SI of paraspinal muscle activity in AIS patients vary with posture changes. Asymmetrical sEMG activity of the paraspinal muscles may be not an inherent feature of AIS patients, but is evident in the challenging tasks. The potential significance of asymmetric paraspinal muscle activity need to be explored in further research.
METHODS: This was a single-center prospective study of 27 patients with single-curve idiopathic scoliosis. Posteroanterior whole-spine radiographs and sEMG activity of the erector spinae muscles were obtained for all patients in the habitual standing position (HSP), relaxed prone position (RPP), and prone extension position (PEP). The Cobb angle, symmetrical index (SI) of the sEMG activity (convex/concave), and correlation between the two factors were analyzed.
RESULTS: In the total cohort, the mean Cobb angle in the HSP was significantly greater than the mean Cobb angle in the RPP (RPP-Cobb) (p < 0.001), whereas the mean Cobb angle in the PEP (PEP-Cobb) did not differ from the RPP-Cobb. Thirteen patients had a PEP-Cobb that was significantly smaller than their RPP-Cobb (p = 0.007), while 14 patients had a PEP-Cobb that was significantly larger than their RPP-Cobb (p < 0.001). In the total cohort and two subgroups, the SI of sEMG activity at the apex vertebra (AVSI) in the PEP was significantly greater than 1, revealing significant asymmetry, and was also significantly larger than the AVSI in the RPP. In the RPP, the AVSI was close to 1 in the total cohort and two subgroups, revealing no significant asymmetry.
CONCLUSIONS: The coronal Cobb angle and the SI of paraspinal muscle activity in AIS patients vary with posture changes. Asymmetrical sEMG activity of the paraspinal muscles may be not an inherent feature of AIS patients, but is evident in the challenging tasks. The potential significance of asymmetric paraspinal muscle activity need to be explored in further research.
摘要：
背景：特发性脊柱侧凸患者通常表现为椎旁肌不平衡。然而,目前尚不清楚这种肌肉失衡是否是特发性脊柱侧凸的根本原因或结果。本研究旨在基于表面肌电图（sEMG）和影像学分析，研究椎旁肌在特发性脊柱侧凸发展中的作用。
方法：这是一项对27例单曲线特发性脊柱侧凸患者的单中心前瞻性研究。在习惯性站立位（HSP）的所有患者中，均获得了后前全脊柱X光片和竖脊肌的sEMG活性，放松俯卧位（RPP），和俯卧伸展位置（PEP）。Cobb角,sEMG活动的对称指数(SI)(凸/凹)，并对两个因素进行相关性分析。
结果：在总队列中，HSP中的平均Cobb角显着大于RPP中的平均Cobb角（RPP-Cobb）（p<0.001），而PEP（PEP-Cobb）中的平均Cobb角与RPP-Cobb没有差异。13例患者的PEP-Cobb明显小于RPP-Cobb（p=0.007），而14例患者的PEP-Cobb显著大于其RPP-Cobb(p<0.001)。在整个队列和两个亚组中，PEP中顶点椎骨的sEMG活动（AVSI）的SI显着大于1，显示出明显的不对称性，并且在RPP中也明显大于AVSI。在RPP中,在整个队列和两个亚组中，AVSI接近1，没有明显的不对称性。
结论：AIS患者的冠状Cobb角和椎旁肌活动的SI随姿势变化而变化。椎旁肌的不对称sEMG活动可能不是AIS患者的固有特征，但在具有挑战性的任务中很明显。不对称椎旁肌活动的潜在意义需要进一步研究。
方法：这是一项对27例单曲线特发性脊柱侧凸患者的单中心前瞻性研究。在习惯性站立位（HSP）的所有患者中，均获得了后前全脊柱X光片和竖脊肌的sEMG活性，放松俯卧位（RPP），和俯卧伸展位置（PEP）。Cobb角,sEMG活动的对称指数(SI)(凸/凹)，并对两个因素进行相关性分析。
结果：在总队列中，HSP中的平均Cobb角显着大于RPP中的平均Cobb角（RPP-Cobb）（p<0.001），而PEP（PEP-Cobb）中的平均Cobb角与RPP-Cobb没有差异。13例患者的PEP-Cobb明显小于RPP-Cobb（p=0.007），而14例患者的PEP-Cobb显著大于其RPP-Cobb(p<0.001)。在整个队列和两个亚组中，PEP中顶点椎骨的sEMG活动（AVSI）的SI显着大于1，显示出明显的不对称性，并且在RPP中也明显大于AVSI。在RPP中,在整个队列和两个亚组中，AVSI接近1，没有明显的不对称性。
结论：AIS患者的冠状Cobb角和椎旁肌活动的SI随姿势变化而变化。椎旁肌的不对称sEMG活动可能不是AIS患者的固有特征，但在具有挑战性的任务中很明显。不对称椎旁肌活动的潜在意义需要进一步研究。
