目的:椎旁肌成像与改善表型相关的兴趣日益增加,预后,和常见脊柱疾病的治疗。我们回顾了与椎旁肌肉成像测量相关的问题,这些问题导致研究之间的发现不一致并阻碍了理解。
方法:回顾了导致椎旁肌成像测量研究不一致的三个主要因素:未能考虑椎旁肌变化的可能机制,缺乏对混杂因素的控制,以及脊髓肌成像模式和测量方案的变化。提出了解决这些问题的建议,以提高未来研究的质量和连贯性。
结果:椎旁肌在急性或慢性阶段对各种常见脊柱疾病的可能病理生理反应往往被忽视,但对时机有重要影响,分布,以及椎旁肌肉变化的性质。这些考虑,以及对可能的混杂因素的调整,比如性,年龄,在脊柱疾病研究中规划和解释椎旁肌肉测量时,必须考虑体力活动。采用用于椎旁肌肉形态和成分的标准化成像测量方案,考虑到各种成像方式的优势和局限性,对研究的解释和综合至关重要。
结论:研究设计考虑了肌肉的生理和病理生理反应,调整可能的混杂因素,并使用常见的,需要采取标准化措施,以提高对椎旁肌肉变化或变化的决定因素及其对脊柱健康的影响的认识。
OBJECTIVE: Paraspinal muscle imaging is of growing interest related to improved phenotyping, prognosis, and treatment of common spinal disorders. We reviewed issues related to paraspinal muscle imaging measurement that contribute to inconsistent findings between studies and impede understanding.
METHODS: Three key contributors to inconsistencies among studies of paraspinal muscle imaging measurements were reviewed: failure to consider possible mechanisms underlying changes in paraspinal muscles, lack of control of confounding factors, and variations in spinal muscle imaging modalities and measurement protocols. Recommendations are provided to address these issues to improve the quality and coherence of future research.
RESULTS: Possible pathophysiological responses of paraspinal muscle to various common spinal disorders in acute or chronic phases are often overlooked, yet have important implications for the timing, distribution, and nature of changes in paraspinal muscle. These considerations, as well as adjustment for possible confounding factors, such as sex, age, and physical activity must be considered when planning and interpreting paraspinal muscle measurements in studies of spinal conditions. Adoption of standardised imaging measurement protocols for paraspinal muscle morphology and composition, considering the strengths and limitations of various imaging modalities, is critically important to interpretation and synthesis of research.
CONCLUSIONS: Study designs that consider physiological and pathophysiological responses of muscle, adjust for possible confounding factors, and use common, standardised measures are needed to advance knowledge of the determinants of variations or changes in paraspinal muscle and their influence on spinal health.