CAJ | 학술논문

目的：明确慢性腰痛对脊旁多裂肌净横截面积大小及脂肪化程度的影响。方法：2010年3月至2013年8月对门诊治疗的腰痛患者进行回顾性分析，最终筛选出31例符合非特异性慢性腰痛患者，其中男19例，女12例；年龄23～55岁，平均36．4岁。主要症状是反复腰痛，病程大于1年，X线、CT、MRI均未见明显异常。采用MRI成像测量同一病例先后不同时间点多裂肌净横截面积及T2信号比率的变化，再获取2次MRI检查时VAS和Oswestry功能障碍评分，分析先后2次测量多裂肌净面积及T2信号比率的变化与腰痛的病程、VAS、Oswestry功能障碍评分的相关性，从而得出腰痛对脊旁多裂肌的影响。结果：同一病例第2次MRI检查多裂肌净横截面积明显小于第1次MRI检查，T2信号比率则明显高于第1次MRI检查（P＜0．05）。多裂肌净横截面积减小率与VAS评分、病程和Oswestry功能障碍评分均呈正相关（P＜0．001），而T2信号比率增加率与VAS评分、病程和Oswestry功能障碍评分均无相关性（P＞0．05）。结论：慢性腰痛是脊旁多裂肌萎缩和脂肪化的重要原因，腰痛时间、程度和功能障碍程度均与多裂肌萎缩呈正相关。
목적：명학만성요통대척방다렬기정횡절면적대소급지방화정도적영향。방법：2010년3월지2013년8월대문진치료적요통환자진행회고성분석，최종사선출31례부합비특이성만성요통환자，기중남19례，녀12례；년령23～55세，평균36．4세。주요증상시반복요통，병정대우1년，X선、CT、MRI균미견명현이상。채용MRI성상측량동일병례선후불동시간점다렬기정횡절면적급T2신호비솔적변화，재획취2차MRI검사시VAS화Oswestry공능장애평분，분석선후2차측량다렬기정면적급T2신호비솔적변화여요통적병정、VAS、Oswestry공능장애평분적상관성，종이득출요통대척방다렬기적영향。결과：동일병례제2차MRI검사다렬기정횡절면적명현소우제1차MRI검사，T2신호비솔칙명현고우제1차MRI검사（P＜0．05）。다렬기정횡절면적감소솔여VAS평분、병정화Oswestry공능장애평분균정정상관（P＜0．001），이T2신호비솔증가솔여VAS평분、병정화Oswestry공능장애평분균무상관성（P＞0．05）。결론：만성요통시척방다렬기위축화지방화적중요원인，요통시간、정도화공능장애정도균여다렬기위축정정상관。
Objective:To identify the affect of chronic low back pain on multifidus muscle atrophy and fatty infiltration. Methods:From March 2010 to August 2013,a retrospective study were carried out in the department of orthopedics of patients with low back pain. Finally 31 cases were selected to this study including 19 males and 12 females with an average age of 36.4 years ranging from 23 to 55 years. The main symptoms of these patients were repeated back pain. Duration was more than 1 year. X ray,CT,MRI showed no obvious abnormalities. The changes of net cross sectional area of multifidus and T2 signal ratio of the same patient were measured at different time by MRI. VAS and Oswestry disability scores were recorded in two MRI ex-amination. Correlation between these change of multifidus net area and T2 signal ratio in two times measurement and duration of low back pain,VAS,Oswestry disability scores were analyzed to find the affection of low back pain on paraspinal multifidus muscle. Results:The net multifidus cross sectional area in same case by the second follow up MRI is significantly smaller than that of the first follow up,T2 signal ratio at second was significantly higher than that of the first (P<0.05). The net cross sec-tional area of multifidus muscles reduced rate were positively correlated with VAS scores ,duration and of Oswestry disabilitry scores (P<0.001). The rate of increase in T2 signal ratio was not correlated with VAS scores ,duration and the Oswestry dis-ability scores (P>0.05). Conclusion:Chronic low back pain is one of the most important reasons of paraspinal multifidus mus-cle atrophy and fatty. The duration,VAS and Oswestry disability scores of chronic low back pain were positively correlated with the multifidus muscle atrophy.