目的 基于CT影像学资料比较下肢痛型与腰腿痛型腰椎间盘突出症（LDH）患者腰大肌的形态学差异。 方法 纳入解放军联勤保障部队第九〇〇医院神经外科自2012年1月至2023年2月收治的60例LDH患者进行研究。根据患者临床症状将其分为下肢痛组与腰腿痛组（各30例）。将2组患者腰大肌CT影像进行三维重建，以垂直于腰大肌纵轴的最长横轴所在平面为横截面，计算腰大肌最大横截面积，以腰大肌最大横截面积与L5椎体横截面积之比为腰大肌最大横截面积指数。比较下肢痛组与腰腿痛组患者腰大肌最大横截面积指数差异，并进一步比较下肢痛组与腰腿痛组组内不同疼痛程度[采用视觉模拟量表（VAS）评分评价]、不同疼痛病程患者间腰大肌最大横截面积指数差异。采用Pearson相关性分析检验2组患者腰大肌最大横截面积指数与疼痛程度、疼痛病程的相关性。 结果 下肢痛组患者腰大肌最大横截面积指数明显大于腰腿痛组患者（0。62±0。05 vs。 0。54±0。04），差异有统计学意义（t=7。320，P<0。001）。下肢痛组、腰腿痛组患者中重度疼痛患者腰大肌最大横截面积指数均明显小于中度疼痛患者（0。61±0。05vs。 0。65±0。04；0。53±0。03 vs。 0。58±0。04），差异均有统计学意义（t=2。422，P=0。022；t=3。502，P=0。002）。下肢痛组、腰腿痛组患者中短病程患者腰大肌最大横截面积指数均明显大于长病程患者（0。64±0。05 vs。 0。59±0。04；0。57±0。04 vs。 0。53±0。03），差异均有统计学意义（t=2。570，P=0。016；t=2。941，P=0。007）。Pearson相关性分析结果显示，2组LDH患者腰大肌最大横截面积指数与疼痛程度、疼痛病程均呈负相关关系（P<0。05）。 结论 LDH患者腰大肌的萎缩程度随疼痛程度、疼痛病程的增加而加重。 Objective To compare the morphological differences of psoas major muscles between patients with lumbar disc herniation (LDH) of lower limb pain and lumbocrural pain based on CT imaging data。 Methods Sixty patients with LDH admitted to Department of Neurosurgery， 900th Hospital of PLA Joint Logistic Team from January 2012 to February 2023 were included。 According to clinical symptoms， they were divided into lower limb pain group and lumbocrural pain group (n=30)。 3D CT images of the psoas major muscles in the 2 groups were reconstructed the longest transverse axis perpendicular to the longitudinal axis of the psoas major muscle was chosen as the cross-sectional area， and the maximum psoas major muscle cross-sectional area was calculated maximum psoas major muscle cross-sectional area index (PImax) was defined as ratio of maximum psoas major muscle cross-sectional area and L5 vertebral cross-sectional area。 PImax difference between lower limb pain group and lumbocrural pain group was compared PImax difference among patients with different pain degrees (visual analog scale [VAS] scores) or pain courses was further compared in both lower limb pain group and lumbocrural pain group。 Pearson correlation was used to analyze the correlations of PImax with pain degree and pain course in the 2 groups。 Results PImax in lower limb pain group was significantly larger than that in lumbocrural pain group (0。62±0。05 vs。 0。54±0。04， t=7。320， P<0。001)。 PImax in patients with severe pain from both lower limb pain group and lumbocrural pain group was significantly smaller than that in patients with moderate pain (0。61±0。05 vs。 0。65±0。04， t=2。422， P=0。022 0。53±0。03 vs。 0。58±0。04， t=3。502， P=0。002)。 PImax in patients with short pain course from both lower limb pain group and lumbocrural pain group was significantly larger than that in patients with long pain course (0。64±0。05 vs。 0。59±0。04， t=2。570， P=0。016 0。57±0。04 vs。 0。53±0。03， t=2。941， P=0。007)。 Pearson correlation showed that PImax was negatively correlated with pain degree and pain course in LDH patients from both groups (P<0。05)。 Conclusion Atrophy of psoas major muscles in LDH patients is aggravated with increased pain degree and pain course。
Comparison of psoas major muscle morphology in patients with lumbar disc herniation of lower limb pain and lumbocrural pain
Objective To compare the morphological differences of psoas major muscles between patients with lumbar disc herniation (LDH) of lower limb pain and lumbocrural pain based on CT imaging data. Methods Sixty patients with LDH admitted to Department of Neurosurgery, 900th Hospital of PLA Joint Logistic Team from January 2012 to February 2023 were included. According to clinical symptoms, they were divided into lower limb pain group and lumbocrural pain group (n=30). 3D CT images of the psoas major muscles in the 2 groups were reconstructed the longest transverse axis perpendicular to the longitudinal axis of the psoas major muscle was chosen as the cross-sectional area, and the maximum psoas major muscle cross-sectional area was calculated maximum psoas major muscle cross-sectional area index (PImax) was defined as ratio of maximum psoas major muscle cross-sectional area and L5 vertebral cross-sectional area. PImax difference between lower limb pain group and lumbocrural pain group was compared PImax difference among patients with different pain degrees (visual analog scale [VAS] scores) or pain courses was further compared in both lower limb pain group and lumbocrural pain group. Pearson correlation was used to analyze the correlations of PImax with pain degree and pain course in the 2 groups. Results PImax in lower limb pain group was significantly larger than that in lumbocrural pain group (0.62±0.05 vs. 0.54±0.04, t=7.320, P<0.001). PImax in patients with severe pain from both lower limb pain group and lumbocrural pain group was significantly smaller than that in patients with moderate pain (0.61±0.05 vs. 0.65±0.04, t=2.422, P=0.022 0.53±0.03 vs. 0.58±0.04, t=3.502, P=0.002). PImax in patients with short pain course from both lower limb pain group and lumbocrural pain group was significantly larger than that in patients with long pain course (0.64±0.05 vs. 0.59±0.04, t=2.570, P=0.016 0.57±0.04 vs. 0.53±0.03, t=2.941, P=0.007). Pearson correlation showed that PImax was negatively correlated with pain degree and pain course in LDH patients from both groups (P<0.05). Conclusion Atrophy of psoas major muscles in LDH patients is aggravated with increased pain degree and pain course.
万方数据
