中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (9): 1402-1406.doi: 10.12307/2022.436

• 脊柱植入物 spinal implant • 上一篇    下一篇

青少年特发性脊柱侧凸患者凸凹侧椎旁肌肌电比值与Cobb角、顶椎偏距、冠状面平衡距离的相关性

王  帅1，王连成2，张书豪3，李富丽3，董佳兴1，张亚杰1   

  1. 1天津中医药大学研究生院，天津市   301617；2天津医院康复科，天津市   300202；3天津体育学院社会体育与健康科学学院，天津市   301617
  • 收稿日期:2021-06-21 修回日期:2021-06-28 接受日期:2021-07-21 出版日期:2022-03-28 发布日期:2021-12-10
  • 通讯作者: 王连成，博士，主任医师，研究生导师，天津医院康复科，天津市 300202
  • 作者简介:王帅，男，1996年生，山西省晋城市人，天津中医药大学在读硕士，主要从事脊柱侧凸保守治疗研究。
  • 基金资助:
    天津市卫生健康委员会项目(ZC20196) ，项目负责人：王连成

Correlation of the electromyography ratio of the paraspinal muscles on the convex and concave sides with Cobb angle, apical vertebra translation, and coronal balance distance in adolescent idiopathic scoliosis patients

Wang Shuai1, Wang Liancheng2, Zhang Shuhao3, Li Fuli3, Dong Jiaxing1, Zhang Yajie1   

  1. 1Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; 2Department of Rehabilitation, Tianjin Hospital, Tianjin 300202, China; 3School of Social Sports and Health Science, Tianjin University of Sport, Tianjin 301617, China
  • Received:2021-06-21 Revised:2021-06-28 Accepted:2021-07-21 Online:2022-03-28 Published:2021-12-10
  • Contact: Wang Liancheng, MD, Chief physician, Master’s supervisor, Department of Rehabilitation, Tianjin Hospital, Tianjin 300202, China
  • About author:Wang Shuai, Master candidate, Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
  • Supported by:
    Tianjin Municipal Health Commission Project, No. ZC20196 (to WLC)

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摘要：

文题释义：
椎旁肌肌电：正常的肌肉收缩产生生物电活动，用表面肌电记录设备可以搜集到脊柱两侧肌肉即椎旁肌肌电信号。最常用的代表肌电信号值强弱的参数是均方根值，均方根值反映肌肉的效能，运动中肌肉收缩程度越大，均方根值越高；静息状态下搜集到的均方根值代表肌肉张力。
冠状面参数：对青少年特发性脊柱侧凸的评估通常在三维平面上进行，即冠状面、矢状面和水平面。冠状面参数如Cobb角、顶椎偏距、冠状面平衡距离等往往反映脊柱侧凸的严重程度。

背景：国外关于青少年特发性脊柱侧凸患者的表面肌电研究报道结果尚有争议，急需相关研究来完善脊柱侧凸患者椎旁肌肌电理论体系。
目的：分析青少年特发性脊柱侧凸患者站立位静息状态下脊柱两侧椎旁肌肌电变化规律，并对患者凸凹侧椎旁肌肌电比值与Cobb角、顶椎偏距、冠状面平衡距离的相关性进行分析。
方法：选取天津医院脊柱侧凸专病门诊青少年特发性脊柱侧凸患者21例，所有患者在站立位静息状态下用T7550表面肌电记录仪记录脊柱两侧椎旁肌均方根值，分析其变化规律及与侧凸患者冠状面参数之间的相关性。研究方案的实行符合《赫尔辛基宣言》及天津医院对研究的相关伦理要求，参与研究的患者及监护人对测试及试验过程均知情同意。
结果与结论：①青少年特发性脊柱侧凸患者站立位静息状态下主弯凸侧与凹侧均方根值差异有显著性意义(P=0.005)；患者凸侧椎旁肌的均方根均值大于凹侧的均方根均值；顶椎凸侧椎旁肌均方根值显著大于凹侧；②患者站立位静息状态下凸凹侧均方根值比值与Cobb角具有强的正相关性(r=0.620，P=0.003)；与顶椎偏距有中等强度相关性(r=0.443，P=0.044)；与冠状面平衡距离无相关性(r=-0.430，P=0.052)；③结果说明，青少年特发性脊柱侧凸患者维持身体站立位时凹凸侧椎旁肌肌张力明显不平衡，凸侧肌张力更强，且在顶椎区域最为明显；椎旁肌凸凹侧均方根值比值随Cobb角、顶椎偏距的增大而增大；随着侧凸加重、顶椎偏离中线越远，维持躯干于直立状态所需的凹凸侧肌肉张力差异越明显。

https://orcid.org/0000-0001-6839-5043 (王帅) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 青少年特发性脊柱侧凸, 椎旁肌, 表面肌电, 冠状面参数, 相关性, Cobb角, 顶椎偏距, 冠状面平衡

Abstract: BACKGROUND: At present, there is a lack of research on paraspinal electromyography in adolescent idiopathic scoliosis, so there is an urgent need for related research to improve the theoretical system of paraspinal electromyography in patients with scoliosis.  
OBJECTIVE: To analyze electromyographic changes of paraspinal muscles on both sides of the spine in adolescent idiopathic scoliosis patients in a resting state and standing position, and analyze the correlation of electromyography ratio of paraspinal muscles on convex and concave sides with Cobb angle, apical vertebra translation, and coronal balance distance.
METHODS:  A total of 21 adolescent idiopathic scoliosis patients were selected from the Scoliosis Clinic of Tianjin Hospital. Root mean square values of paraspinal muscles on both sides of the spine were recorded by Canadian T7550 surface electromyography in a resting state and standing position. The correlation between its variation and coronal plane parameters in patients with scoliosis was analyzed. The protocol complied with the Declaration of Helsinki and the relevant ethical requirements of Tianjin Hospital. The patients and guardians participating in the research had informed consent to the test and the trial process.  
RESULTS AND CONCLUSION: (1) Root mean square values of the convex side of the main curve and the concave side of the adolescent idiopathic scoliosis patients in the standing position and resting state were significantly different (P=0.005). Root mean square values of the convex side of the main curve were greater than those of the concave side, and the root mean square values of the convex side of the apical cone were significantly greater than those of the concave side. (2) There was a strong positive correlation between root mean square ratio of convex-concave side and Cobb angle in patients in standing and resting state (r=0.620, P=0.003); there was a moderate correlation with apical vertebra translation (r=0.443, P=0.044); however, there was a correlation with coronal plane equilibrium distance (r=-0.430, P=0.052). (3) These results indicate that in patients with adolescent idiopathic scoliosis, the tension of paravertebral muscles on the concavo-convex side was obviously unbalanced when maintaining a standing position, and the tension on the convex side was stronger, which was most obvious in the apical cone region. The ratio of root mean square on the concave-convex side of paravertebral muscles in patients with adolescent idiopathic scoliosis in standing and resting states increased with the increase of Cobb angle and apical vertebra translation. As scoliosis increases and the cone offset increases, the difference in the muscle tension required to maintain the trunk in an upright position becomes more pronounced.

Key words: adolescent idiopathic scoliosis, paraspinal muscle, surface electromyography, coronal plane parameters, correlation, Cobb angle, apical vertebra translation, coronal balance

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