脊柱甘露语林:“于诸病苦,为作良医;于失道者,示其正路;于暗夜中,为作光明;于贫穷者,令得伏藏。”脊柱甘露语林学术•疾病与健康科普•助学公益平台,以杏林春满为愿景,致力于探索普及青少年特发性脊柱侧弯AIS自然史、低电离辐射拍片法等领域,跬步前行,已5年余。
本文由“脊柱甘露语林”微信公众号平台原创,脊柱甘露语林公众号《jzglyl》
原创作者:王海强,张军
腰痛与椎旁筋膜肌肉
椎旁肌肉概述
腰突与多裂肌改变:显微观
腰突与多裂肌改变:MRI观
神经根压迫致病侧多裂肌萎缩之学派
图7 腰4/5椎间盘突出,偏右侧之矢状位(a)、轴位(b);多裂肌至椎板之垂直间距:病侧(c)>健侧(d);多裂肌横截面积:病侧(e)<健侧(f);
腰突病侧多裂肌并无萎缩之学派
加拿大阿尔伯塔大学Niemeläinen、Battié和Fortin等,为此学派之代表。
结语
脂肪中等,关节突内聚、增生
参考文献
1.Zhao WP, Kawaguchi Y, Matsui H, Kanamori M, Kimura T. Histochemistry and morphologyof the multifidus muscle in lumbar disc herniation: comparative study betweendiseased and normal sides. Spine (Phila Pa 1976). 2000 Sep 1;25(17):2191-9.PMID: 10973402.
2.Yoshihara K, Shirai Y, Nakayama Y, Uesaka S. Histochemical changes in the multifidusmuscle in patients with lumbar intervertebral disc herniation. Spine (Phila Pa1976). 2001 Mar 15;26(6):622-6. PMID: 11246373.
3. HyunJK, Lee JY, Lee SJ, Jeon JY. Asymmetric atrophy of multifidus muscle inpatients with unilateral lumbosacral radiculopathy. Spine. 2007;32:598–602.
4. AltinkayaN, Cekinmez M. Lumbar multifidus muscle changes in unilateral lumbar disc herniationusing magnetic resonance imaging. Skeletal Radiol. 2016 Jan;45(1):73-7. PMID:26377578.
5.Niemeläinen R, Briand MM, Battié MC. Substantial asymmetry in paraspinal musclecross-sectional area in healthy adults questions its value as a marker of lowback pain and pathology. Spine (Phila Pa 1976). 2011 Dec 1;36(25):2152-7. PMID:21343855.
6.Battié MC, Niemelainen R, Gibbons LE, Dhillon S. Is level- and side-specific
multifidusasymmetry a marker for lumbar disc pathology? Spine J. 2012 Oct;12(10):932-9.PMID: 23084154.
7. Fortin M, Lazáry À, Varga PP, McCall I, Battié MC. Paraspinal muscleasymmetry and fat infiltration in patients with symptomatic disc herniation.Eur Spine J. 2016 May;25(5):1452-9. PMID: 26957101
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