Diagnostic value of functional relative cross-sectional area of paraspinal muscles in lumbar disc herniation and the relationship with disc degeneration
Objective To investigate the diagnostic value of the functional relative cross-sectional area(CSA)of paraspinal muscles in lumbar disc herniation(LDH)and its relationship with disc degeneration.Methods Ninety-six LDH patients treated at our hospital from June 2020 to August 2023 were selected as the observation group,and 50 individuals without lumbar degenerative diseases who underwent lumbar MRI during the same period were selected as the control group.The observation group's L4/L5 and L5/S1 discs were graded according to the Pfirrmann classification.ImageJ software was used to measure the paraspinal muscle CSA,muscle fat infiltration CSA,and disc CSA in both groups,and the functional relative CSA was calculated.The functional relative CSA of the paraspinal muscles was compared between the two groups.The di-agnostic value of functional relative CSA for LDH was analyzed using ROC curves,and the relationship between disc degen-eration severity and functional relative CSA was analyzed along with the influencing factors.Results The functional relative CSA of the L/S1 and L4/L5 discs in the control group was significantly larger than that in the observation group(P＜0.05).Significant differences were found in the functional relative CSA of the psoas major,multifidus,and erector spinae among patients with different disc degeneration grades in the observation group(P＜0.05).Correlation analysis showed that at the L5/S1 level,the correlation coefficients(rs)between the functional relative CSA of the psoas major,multifidus,erector spi-nae,and disc degeneration severity were-0.388,-0.344,and-0.360,respectively(P＜0.001);at the L4/L5 level,the rs values were-0.500,-0.489,and-0.501(P＜0.001).The AUCs for diagnosing LDH using the functional relative CSA of the psoas major,multifidus,and erector spinae at the L5/S1 level were 0.892(95% CI:0.830-0.937),0.911(95% CI:0.852-0.951),and 0.640(95% CI:0.557-0.718),respectively;at the L4/L5 level,the AUCs were 0.850(95% CI:0.782-0.904),0.919(95% CI:0.862-0.958),and 0.848(95% CI:0.780-0.902).Regression analysis showed that disc degeneration severity was an independent influencing factor for functional relative CSA(P＜0.05).Conclu-sion Functional relative CSA of the paraspinal muscles has an important reference value for diagnosing LDH and is nega-tively correlated with disc degeneration severity.Disc degeneration is an independent influencing factor for paraspinal muscle degeneration.
万方数据
维普
