腰椎滑脱症椎旁肌变化的系统综述：MRI和CT见解
Systematic Review of Paraspinal Muscle Changes in Lumbar Spondylolisthesis: MRI and CT Insights.
摘要(中文译文)
脊椎滑脱是骨科常见疾病，其动态稳定性主要依靠椎旁肌维持。本系统综述评估腰椎滑脱（LS）患者椎旁肌——具体为多裂肌、竖脊肌和腰大肌——的横截面积（CSA）和脂肪浸润（FI），以了解其在退行性和峡部型滑脱中对脊柱稳定性和疾病进展的作用。按照PRISMA指南，检索了截至2024年9月的PubMed、Cochrane和Scopus数据库。共纳入14项使用MRI/CT成像的回顾性研究，聚焦于LS中的CSA和FI。数据提取自通过椎体滑移测量或与无症状对照比较来评估脊柱不稳定性的研究。研究结果表明，椎旁肌（尤其是多裂肌）CSA减少和FI增加与脊柱不稳定性及进行性椎体滑移相关。多项研究报告了脊椎滑脱患者CSA减少和FI增加，尽管各研究的方法和解剖节段存在差异。观察到竖脊肌和腰大肌的代偿性肥大，尤其在峡部型病例中。这些发现支持肌肉健康在维持脊柱稳定性中的潜在作用，并提示针对椎旁肌改变的靶向康复策略可能改善LS患者的临床结局。
Abstract
Spondylolisthesis is a frequently encountered condition in orthopedics, requiring dynamic stability maintained primarily by the paraspinal muscles. This systematic review evaluates the cross-sectional area (CSA) and fat infiltration (FI) of paraspinal muscles-specifically the multifidus, erector spinae, and psoas major-in lumbar spondylolisthesis (LS) to understand their roles in spinal stability and progression in degenerative and isthmic forms. Following PRISMA guidelines, PubMed, Cochrane, and Scopus were searched as of September 2024. Fourteen retrospective studies using MRI/CT imaging met inclusion criteria, focusing on CSA and FI in LS. Data were extracted from studies that assessed spinal instability through vertebral slippage measurements or comparisons with asymptomatic controls. The findings indicate that reduced CSA and increased FI in paraspinal muscles, especially the multifidus, are associated with spinal instability and progressive vertebral slippage. Several studies reported reductions in CSA and increases in FI in patients with spondylolisthesis, although methods and anatomical levels varied across studies. Compensatory hypertrophy of the erector spinae and psoas major was observed, particularly in isthmic cases. These findings support the potential role of muscle health in maintaining spinal stability and suggest that targeted rehabilitation strategies addressing paraspinal muscle alterations may improve clinical outcomes in patients with LS.
如何引用
AMA
Valerio D'Andrea, Caterina Bernetti, Federico Greco, Claudia Volterrani, Carlo C Quattrocchi, Paul M Parizel, et al. Systematic Review of Paraspinal Muscle Changes in Lumbar Spondylolisthesis: MRI and CT Insights.. Orthopaedic surgery. 2026; doi:10.1111/os.70362.
APA
Valerio D'Andrea, Caterina Bernetti, Federico Greco, Claudia Volterrani, Carlo C Quattrocchi, Paul M Parizel, et al (2026). Systematic Review of Paraspinal Muscle Changes in Lumbar Spondylolisthesis: MRI and CT Insights.. Orthopaedic surgery. https://doi.org/10.1111/os.70362
GB/T 7714
Valerio D'Andrea, Caterina Bernetti, Federico Greco, Claudia Volterrani, Carlo C Quattrocchi, Paul M Parizel, et al. Systematic Review of Paraspinal Muscle Changes in Lumbar Spondylolisthesis: MRI and CT Insights.[J]. Orthopaedic surgery, 2026 doi:10.1111/os.70362.
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