Study On The Correlation Between Multifidus Muscle Degeneration And Lumbar Disc Herniation In Based On The Theory Of "Attaching Equal Importance To Muscles And Bones"

Objective:based on the theory of"attaching equal importance to muscles and bones"in traditional Chinese medicine,to study and compare the cross-sectional area and atrophy degree of cleft muscle between healthy adolescents and adolescent patients with lumbar disc herniation,and use VAS score,JOA score and ODI score as observation indexes to analyze the correlation between atrophy and clinical symptoms,so as to provide reference for the pathogenesis,diagnosis and treatment of adolescent patients with lumbar disc herniation.Methods:A total of 40 patients with lumbar disc herniation diagnosed as adolescents who met the diagnostic and inclusion criteria from January 2021 to December 2022 in Gansu Provincial Hospital of Traditional Chinese Medicine were selected,and 20 healthy adolescents were recruited.Forty adolescent patients with lumbar disc herniation were assigned to the disease group,and 20 healthy adolescents were assigned to the health group.Collect MRI imaging data of the two groups,observe and compare the cross-sectional area and degree of atrophy of the multifidus muscle in the two groups,and record the VAS score,JOA score,and ODI score.SPSS26.0 statistical software was used for data analysis to compare the differences in the cross-sectional area and degree of atrophy of the multifidus muscle between the two groups,and to analyze the correlation between the degree of multifidus muscle atrophy and clinical symptoms in adolescent patients with lumbar disc herniation.Result:1.Comparison of general data:The gender of the two groups passed the Chi-square test,and the age passed the independent sample Independent sample t-test.The result P>0.05,the difference is not statistically significant,and the general statistics of the two groups are considered to be comparable.2.Comparison of the cross-sectional area of the multifidus muscle between the two groups:The total area of the L4/5 segment multifidus muscle in the disease group was(17.11±3.46)cm~2,while the total area of the L4/5 segment multifidus muscle in the health group was(17.22±3.75)cm~2.There was no significant difference between the two groups(P>0.05);The net area of the L4/5 segment multifidus muscle in the disease group was(12.50±2.85)cm~2,while the net area of the L4/5 segment multifidus muscle in the health group was(15.24±3.70)cm~2,with a statistically significant difference between the two groups(P<0.05);The total area of the L5/S1 segment multifidus muscle in the disease group was(20.64±5.08)cm~2,while the total area of the L5/S1 segment multifidus muscle in the health group was(20.24±3.58)cm~2.There was no statistically significant difference between the two groups(P>0.05);The net area of multifidus muscle in the L5/S1 segment of the disease group was(14.65±3.77)cm~2,while the net area of multifidus muscle in the L5/S1 segment of the health group was(17.15±2.96)cm~2,with a statistically significant difference between the two groups(P<0.05).3.Comparison of the FCSA/TCSA ratio at the same level of the same segment between the two groups:The FCSA/TCSA ratio at the L4/5 protruding segment L4/5 level in the disease group was(72.99±6.67)%,while the FCSA/TCSA ratio at the L4/5 level in the health group was(88.11±4.11)%.The difference between the two groups was statistically significant(P<0.05);The FCSA/TCSA ratio at the L5/S1 level of the L4/5 protruding segment in the disease group was(78.51±4.34)%,while the FCSA/TCSA ratio at the L5/S1 level in the health group was(84.80±4.14)%.The difference between the two groups was statistically significant(P<0.05);The FCSA/TCSA ratio at the L4/5 level of the L5/S1 protruding segment in the disease group was(79.52±6.46)%,while the FCSA/TCSA ratio at the L4/5 level in the health group was(88.11±4.11)%.The difference between the two groups was statistically significant(P<0.05);The FCSA/TCSA ratio at the L5/S1 protrusion level in the disease group was(70.74±5.86)%at the L5/S1 level,while the FCSA/TCSA ratio at the L5/S1 level in the health group was(84.80±4.14)%;There was significant difference between the two groups(P<0.05).4.Comparison of FCSA/TCSA ratios at different levels of the same segment between the two groups:In the disease group,the FCSA/TCSA ratio at the L4/5 protruding segment L4/5level was(72.99±6.67)%,and the FCSA/TCSA ratio at the L5/S1 level was(78.51±4.34)%.There was significant difference between the two groups(P<0.05);In the disease group,the FCSA/TCSA ratio at the L4/5 level of the L5/S1 protruding segment was(79.52±6.46)%,and the FCSA/TCSA ratio at the L5/S1 level was(70.74±.86)%.There was significant difference between the two groups(P<0.05);In the health group,the FCSA/TCSA ratio at L4/5 level was(88.11±4.11)%,and the FCSA/TCSA ratio at L5/S1 level was(84.80±4.14)%.There was significant difference between the two groups(P<0.05).5.Correlation analysis between the degree of multifidus muscle atrophy and clinical symptoms:The VAS score in the disease group was(4.58±1.16)points,with a high negative correlation between the VAS score and the FCSA/TCSA ratio of the protruding segment,and a positive correlation with multifidus muscle atrophy(P<0.01);The JOA score in the disease group was(19.55±2.39)points,with a high positive correlation between the JOA score and the FCSA/TCSA ratio of the protruding segment,and a negative correlation with multifidus atrophy(P<0.01);The ODI score in the disease group was(28.64±7.89)points,with a high negative correlation between the ODI score and the FCSA/TCSA ratio of the protruding segment,and a positive correlation with multifidus atrophy(P<0.01).Conclusion:1.The total cross-sectional area of the multifidus muscle in adolescent patients with lumbar disc herniation has not significantly changed compared to healthy adolescents,but the net cross-sectional area of the multifidus muscle has significantly decreased,and the net cross-sectional area of the multifidus muscle at adjacent segments has also changed,indicating that lumbar disc herniation in adolescents can affect the net cross-sectional area of the multifidus muscle.2.The degree of multifidus muscle atrophy in adolescent patients with lumbar disc herniation is more severe than in healthy adolescents,and the multifidus muscle of adjacent segments also exhibits varying degrees of atrophy,indicating that lumbar disc herniation in adolescents can cause multifidus muscle atrophy.3.There is a correlation between the degree of multifidus muscle atrophy and clinical symptoms in adolescent patients with lumbar intervertebral disc disease.The higher the degree of atrophy,the more severe its impact on the degree of pain,symptoms of low back pain,and normal life.