■探讨颈椎间盘退变与椎旁肌退变的关系[多裂(MF),颈半椎肌(SCer),半壁肌炎(SCap)和脾炎(SPL)]。
■随机选择82例慢性颈痛患者,包括43名男性和39名女性,50.730.7.51岁。所有患者均经3.0TMRIPhilipsIngenia进行常规MRI序列扫描和脂肪测量序列mDIXON-Quant宫颈扫描。颈椎旁肌肉的脂肪浸润(FI)和横截面积(CSA)(MF,SCer,通过飞利浦3.0TMRI图像后处理工作站测量C5-6椎间盘中央水平的SCap和SPL)。根据Pfirrmann分级系统,在纳入的病例中没有一级。IIrIV级病例数分别为n=16、40、19和7。采用t检验或单向方差分析比较颈椎旁肌的CSA和FI。采用Spearman相关分析评价年龄、椎间盘退变,CSA,颈椎旁肌肉的FI,采用多元线性回归分析CSA和FI的独立影响因素。
■男性患者颈椎旁肌肉的CSA明显高于女性患者(均P<0.001),但FI差异无统计学意义(均P>0.05)。年龄与MF+SCer的CSA弱相关,与SCap和SPL的CSA呈中度相关(r=-0.256,-0.355和-0.361,P<0.05),与SCap和SPL的FI弱相关(r=0.182和0.264,P<0.001),与MF+SCer的FI呈中度相关(r=0.408,P<0.001)。椎间盘退变的FI差异有统计学意义(P<0.001,P=0.028和P=0.005)。进一步的相关分析显示,椎间盘退变与MF+SCer的FI密切相关(r=0.629,P<0.001)。与SCap和SPL的FI呈中度相关(r=0.363,P=0.001;r=0.345,P=0.002)。多元线性回归分析显示,性别和年龄是SCap和SPLCSA的影响因素,性别是MF+SCerCSA的独立影响因素,椎间盘退变是FI的独立影响因素。
■年龄与CSA呈负相关,与FI呈正相关。椎间盘退变与椎旁肌FI相关,特别是MF和SCer的FI。性别和年龄是CSA的影响因素,椎间盘退变是FI的独立影响因素。
UNASSIGNED: To investigate the relationship between degeneration of cervical intervertebral disc and degeneration of paravertebral muscles[multifidus (MF), cervical semispinalis (SCer), semispinalis capitis (SCap) and splenius capitis (SPL)].
UNASSIGNED: 82 patients with chronic neck pain were randomly selected, including 43 males and 39 females, with 50.73 0.7.51 years old. All patients were scanned by 3.0T MRI Philips Ingenia performed conventional MRI sequence scanning and fat measurement sequence mDIXON-Quant scanning of cervical. Fat infiltration (FI) and cross-sectional area (CSA) of cervical paravertebral muscle (MF, SCer, SCap and SPL) at central level of C5-6 disc were measured by Philips 3.0T MRI image post-processing workstation. According to Pfirrmann grading system, there was no grade I in the included cases. The number of grade IIr IV cases were n=16, 40, 19 and 7 respectively. CSA and FI of cervical paravertebral muscles were compared with t test or one-way ANOVA, Spearman correlation analysis was used to evaluate the correlation between age, disc degeneration, and CSA, FI of cervical paravertebral muscles, and multiple linear regression analysis was used to analyze the independent influencing factors of CSA and FI.
UNASSIGNED: CSA of cervical paravertebral muscles in male patients was significantly higher than that in female patients (all P<0.001), but there was no significant difference in FI (all P>0.05). Age was weakly correlated with CSA of MF+SCer, moderately correlated with CSA of SCap and SPL (r=-0.256, -0.355 and -0.361, P<0.05), weakly correlated with FI of SCap and SPL (r= 0.182 and 0.264, P<0.001), moderately correlated with FI of MF+SCer (r=0.408, P<0.001). There were significant differences in FI with disc degeneration (P<0.001, P=0.028 and P=0.005). Further correlation analysis showed that disc degeneration was strongly correlated with FI of MF+SCer (r=0.629, P<0.001), and moderately correlated with FI of SCap and SPL (r=0.363, P=0.001; r=0.345, P=0.002). Multiple linear regression analysis showed that sex and age were the influencing factors of CSA of SCap and SPL, sex was the independent influencing factor of CSA of MF+SCer, and disc degeneration was the independent influencing factor of FI.
UNASSIGNED: Age is negatively correlated with CSA and positively correlated with FI. Disc degeneration was correlated with FI of paravertebral muscles, especially with FI of MF and SCer. Sex and age were the influencing factors of CSA, while disc degeneration was the independent influencing factor of FI.