| Objective:To investigate the clinical significance,possible etiology,clinical features and regularity of multifidus degenerationMethods:1.To explore the characteristics of age-related changes of multifidus and the differences of multifidus between male and female,imaging data from 360 cases of healthy subjects aging from 25 to 69,including 180 cases of men and 180 cases of women were analyzed.2.To study the degeneration status of the ipsilateral and contralateral multifidus of corresponding segment,the clinical data of 70 patients with unilateral symptoms of lumbar disc herniation treated in our hospital from January 2012 to June 2016 were analyzed.3.The clinical characteristics and imaging data of 40 patients with degenerative lumbar spinal stenosis treated in our hospital from January 2015 to June 2016 were collected and then compared with those of 40 healthy subjects who were randomly selected in the same period.Results:1.The fat infiltration ratio and muscle asymmetry of multifidus were age-related in both male and female.The fat infiltration and muscle asymmetry of multifidus in healthy subjects increase with advancing age.And the lumbar muscularity of multifidus does not have a significant correlation with age.Among subjects at the age of 25-54 years,the fat infiltration ratio of multifidus was significantly higher in female compared with that in male,while in the group of 55-69 years old,there was no significant difference between male and female.In addition,although the cross-sectional area of multifidus was less in female of all ages,there was no significant difference between male and female in the lumbar muscularity and muscle asymmetry.2.Ipsilateral and contralateral lumbar muscularity(0.444 vs 0.440,P> 0.05)and fatty infiltration ratio(0.171 vs 0.168,P> 0.05)of patients with unilateral lumbar disc herniation whose duration less than six months have no significant differences.Lumbar muscularity in the patients whose duration more than six months,the ipsilateral and contralateral(0.435 vs 0.435,P> 0.05)had no significant difference,while the fat infiltration ratio(0.182 vs 0.169,P <0.05)was statistically significant.3.The LSS group consisted of 40 patients,including 16 men and 24 women,with the mean age of 61.55±3.41 years.The control group also consisted of 40 healthy people,including 18 men and 22 women,with the mean age of 60.38±3.30 years.Thus,gender(?2 =0.20;P=0.651)and age(Z=1.72;P=0.084)did not have statistically significant differences between the two groups.In the LSS group,fatty degeneration ratio(0.265 versus 0.218,P < 0.05)and muscle asymmetry(0.047 versus 0.031,P < 0.05)were significantly higher and lumbar muscularity(0.804 versus 0.873,P < 0.05)was significantly lower as compared with health subjects.Conclusion: 1.Multifidus degeneration will increase with age advancing,which is mainly characterized by increased fat infiltration and bilateral asymmetry,rather than muscle atrophy.2.The cross-sectional area of multifidus was less in female than that of the male,but there was no significant difference in lumbar muscularity between male and female.3.There was no significant difference between male and female in the bilateral asymmetry of multifidus.4.In the 25-54 age group,the fat infiltration ratio of multifidus was significantly higher in female than that of male,while in the 55-69 age group,there is no significant difference between male and female.5.Unilateral lumbar disc herniation with duration more than six months can accelerate the ipsilateral segmental cleft multifidus degeneration,which is mainly characterized by fat infiltration.6.Multifidus degeneration,including reduced volume,increased fatty infiltration,and bilateral muscle asymmetry has association with lumbar spinal stenosis. |
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