| Background and objectives Adolescent idiopathic Scoliosis(AIS)is a three-dimensional structural deformity of the spine of unknown etiology,and its main clinical manifestations are Cobb Angle≥10°on orthographic X-ray.Patients with AIS with paravertebral muscle imbalance or dysfunction are at risk of malformation progression,especially during periods of rapid growth and development.Therefore,it is of important clinical significance to clarify the characteristics of paravertebral muscles in AIS patients and then conduct targeted intervention to correct their abnormalities to prevent the progression of scoliosis.In order to clarify the characteristics of paravertebral muscles in AIS patients,the present study quantified the changes of paravertebral muscles in AIS patients by means of electromyography,magnetic resonance,ultrasound and other imaging methods,and found that some paravertebral muscles such as multifidus muscle and erector spine muscle in scoliosis patients had asymmetric electrical activity or morphological abnormalities.However,the understanding of paravertebral muscle distortion is still incomplete.First,a single muscle with a single bent segment in the multi-rest position;The other is lack of comparison with healthy controls.The effect of dynamic imbalance between paravertebral muscles on spinal stability in AIS patients,and whether paravertebral muscle morphologic abnormalities occur at all levels of the main curve,are not known.Ultrasound has become the preferred method for the diagnosis of musculoskeletal system diseases due to its unique advantages of non-invasive,inexpensive and dynamic monitoring of muscle morphological changes.Therefore,this study aims to quantitatively evaluate the thickness of the concave and convex paravertebral muscles at the level of each vertebral body in the main curve of AIS patients with different body positions by means of ultrasound detection to evaluate the symmetry and morphological characteristics of the paravertebral muscles on both sides of the spine in AIS patients,providing data for etiological research of AIS and the formulation of targeted treatment plans.Methods and materials 1.Twenty-three adolescents whose paravertebral muscle thickness at T12～L5 vertebral levels was determined using US imaging with the subjects in rest and upright standing position,and to evaluate the symmetry of each paravertebral muscle on both sides of the spine of AIS patients.Pearson correlation was used to analyze the correlation between the muscle thickness parameters and the spinal skeletal parameter.2.The researchers compared the thickness and change rate of paravertebral muscle thickness between 23 AIS patients and 23 control groups under different body positions by means of ultrasound detection,and explored the change characteristics of the shape and contractile capacity of each paravertebral muscle in the concave and convexal sides of the patients.Since the muscles on both sides of the spine in the control group were symmetrical,the thickness and thickness change rate of the concave and convex muscles in the patient group were compared with the mean thickness of the left and right sides and the mean thickness change rate of the left and right sides of the muscles in the control group.Result 1.At rest and standing position,significantly greater muscle thicknesses of patients were found on the concave side in the spinal erectors of T12-L4 vertebral levels,the multifidus of T12-S1 vertebral levels,quadratus lumborum and transversus abdominis muscle(only the rest position)compared with the corresponding convex side(P<0.05).The percentage of muscle thickness difference between erector and multifidus at the level of apex vertebra was significantly greater than that at the level of the lower end vertebra(P<0.05).2.The difference index of erector muscle thickness in rest and standing position was positively correlated with the Cobb angle(r=0.732、0.583,P<0.05);The difference index of quadratus lumbar muscle thickness in standing position was positively correlated with Cobb Angle(r=0.433,P<0.05).3.At rest and standing position,significantly smaller muscle thickness were found on the convex side in the spinal erectors,the multifidus,quadratus lumborum and transversus abdominis muscle(only the rest position)in AIS patients compared with controls(P<0.05).Significantly lower thickness change rates of spinal erectors in AIS patients compared with controls(P<0.05).4.In the AIS group,the muscle thickness of erector spinal muscle,multifidus muscle,quadratus lumborum muscle and transverse abdominis muscle increased from resting position to standing position(P<0.05).Conclusion 1.At rest and standing position,AIS patients have paravertebral muscle asymmetry in multiple vertebral segments of the main curved line,and the imbalance degree of erector spine and multifidus muscle was greater at the level of apex vertebrae than at the level of lower end vertebra.2.In AIS patients,the thickness of the transverse abdominis muscle was asymmetrical in the rest position,however this phenomenon disappeared in the standing position,suggesting that patients adjusted the abnormal load of the spine in different positions by changing transverse abdominis muscle activation strategy.3.There is a significant positive correlation between the parameters of erector and quadratus lumborum in AIS patients and the spinal bone parameters,among which the correlation between the thickness difference index of erector at rest position has the strongest correlation with the coronal Cobb Angle.The erector and quadratus lumborum could reflect the degree of coronal imbalance in AIS patients.4.At rest and standing position,the thickness of the paraspinal muscle of AIS patients was thinner than that of the control group in multiple vertebral segments of the main curved line,and the contractile capacity of the erector spinal muscles is less in AIS patients.5.The paravertebral muscle thickness increased in standing position compared with rest position. |
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