中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (24): 3824-3828.doi: 10.3969/j.issn.2095-4344.1223

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

青少年特发性脊柱侧凸患者顶椎椎旁肌表面肌电信号与Cobb角及轴向躯干旋转角的相关性

袁望舒1，陈丽霞1，沈建雄2，王  海2，余可谊2，刘  颖1，周靖雅3，林友禧2 
  

  1. 北京协和医院，1康复科，2骨科，3病案科，北京市  100730
  • 出版日期:2019-08-28 发布日期:2019-08-28
  • 通讯作者: 陈丽霞，硕士，主任医师，北京协和医院康复科，北京市 100730
  • 作者简介:袁望舒，女，1984年生，吉林省长春市人，汉族，2012年吉林大学医学院毕业，硕士，主管技师，主要从事脊柱侧凸的保守治疗。
  • 基金资助:
    北京市卫生和计划生育委员会北京市卫生与健康科技成果和适宜技术推广项目(2018-TG-34)，项目负责人：陈丽霞

Correlation of surface electromyogram signals of the apex vertebral paraspinal muscle with Cobb angle and axial trunk rotation angle in adolescent idiopathic scoliosis patients 

Yuan Wangshu1, Chen Lixia1, Shen Jianxiong2, Wang Hai2, Yu Keyi2, Liu Ying1, Zhou Jingya3, Lin Youxi2 
  

  1. 1Department of Rehabilitation, 2Department of Orthopedics, 3Department of Medical Records, Peking Union Medical College Hospital, Beijing 100730, China
  • Online:2019-08-28 Published:2019-08-28
  • Contact: Chen Lixia, Master, Chief physician, Department of Rehabilitation, Peking Union Medical College Hospital, Beijing 100730, China
  • About author:Yuan Wangshu, Master, Technician-in-charge, Department of Rehabilitation, Peking Union Medical College Hospital, Beijing 100730, China
  • Supported by:
    the Beijing Health and Family Planning Commission Beijing Health and Wellness Science and Technology Achievements and Appropriate Technology Promotion Project, No. 2018-TG-34 (to CLX)

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摘要：

文章快速阅读：

文题释义：
均方根值对比值：表面肌电的均方根值用来评价肌肉的运动状态和静息状态下的水平，它与肌肉功能及神经肌肉效能相关。顶椎凸凹两侧肌肉的均方根的对比值能够体现两侧肌肉的效能差异大小。
轴向躯干旋转角：在Adam’s试验下(受试者自然站立，缓慢弯腰，检查者在其背后观察后背不等高的情况并用scoliometer测量具体角度)，测量患者躯干的旋转，而非X射线片上椎体的旋转。
 
摘要
背景：目前对青少年特发性脊柱侧凸的进展判断主要依靠X射线片，但反复照射X射线存在众多弊端，急需更多的方法来完善诊疗过程。
目的：希望通过采集青少年特发性脊柱侧凸患者顶椎两侧椎旁肌的表面肌电活动信号——均方根值，判断其顶椎两侧椎旁肌肌肉功能是否平衡，探索顶椎两侧均方根对比值、Cobb角和轴向躯干旋转角三者的相关性，试图为临床诊断青少年特发性脊柱侧凸严重程度提供新方法。
方法：选择89例青少年特发性脊柱侧凸患者，平均年龄(14.78±2.20)岁。分别收集所有患者的顶椎两侧椎旁肌均方根值、Cobb角和轴向躯干旋转角度，计算顶椎两侧椎旁肌均方根对比值，并分析顶椎两侧均方根对比值、Cobb角和轴向躯干旋转角三者的相关性。
结果与结论：①青少年特发性脊柱侧凸患者顶椎凸侧椎旁肌的均方根值高于凹侧，差异有显著性意义(P=0.022)；②在所有青少年特发性脊柱侧凸患者中，Cobb角与轴向躯干旋转角呈正相关性(r=0.613，P ≤0.001)，均方根对比值与轴向躯干旋转角呈正相关性(r=0.269，P=0.011)；③在轻中度青少年特发性脊柱侧凸患者中，均方根对比值与Cobb角、轴向躯干旋转角存在良好的正相关性；④结果表明，青少年特发性脊柱侧凸患者顶椎两侧椎旁肌肌肉功能不平衡；在轻中度的青少年特发性脊柱侧凸患者中，顶椎椎旁肌均方根对比值和轴向躯干旋转角度均可间接判断Cobb角的大小。


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
ORCID: 0000-0001-6835-0929(袁望舒)

关键词: 青少年特发性脊柱侧凸, 表面肌电, 均方根值, X射线, Cobb角, 轴向躯干旋转角, 顶椎椎旁肌

Abstract:

BACKGROUND: The progress of adolescent idiopathic scoliosis is evaluated mainly by X-ray films, but there are many drawbacks in repeated exposure to X-rays, and more methods are urgently needed to improve the diagnosis and treatment process.
OBJECTIVE: To determine whether the muscle function of the paraspinal muscles on both sides of the apical vertebrae is balanced by collecting the surface electromyographic activity signal of the paraspinal muscles on both sides of the apical vertebrae in adolescent idiopathic scoliosis, and to explore the correlation of the root mean square contrast value with the Cobb angle and the axial trunk rotation angle on both sides so as to provide a new method for the clinical diagnosis of adolescent idiopathic scoliosis.
METHODS: Eighty-nine patients with adolescent idiopathic scoliosis were selected, with an average age of (14.78±2.20) years. The root mean square values, Cobb angle and axial trunk rotation angle of the paraspinal muscles on both sides of the apical vertebrae were collected. The root mean square contrast values of the paravertebral muscles on both sides of the apical vertebrae were calculated. The correlation of the root mean square contrast value with Cobb angle and axial trunk rotation angle on both sides of the apical vertebrae was analyzed.
RESULTS AND CONCLUSION: (1) The root mean square value of the vertebral paraspinal muscles of the adolescent idiopathic scoliosis was significantly higher than that of the concave side (P=0.022). (2) In all adolescent idiopathic scoliosis patients, the Cobb angle was correlated with the axial trunk rotation angle (r=0.613, P ≤ 0.001), and the root mean square contrast value was correlated with the axial trunk rotation angle (r=0.269, P=0.011). (3) In patients with mild to moderate adolescent idiopathic scoliosis, there was a positive correlation between the root mean square contrast value and the Cobb angle and axial trunk rotation angle. (4) These results indicate that the muscle function of the paraspinal muscles on both sides of the apical vertebrae in adolescent idiopathic scoliosis patients is unbalanced. In patients with mild to moderate adolescent idiopathic scoliosis, the root mean square contrast value of the vertebral paraspinal muscle and the axial trunk rotation angle can indirectly determine the Cobb angle.

Key words: adolescent idiopathic scoliosis, surface electromyography, root mean square, X-ray, Cobb angle, axial trunk rotation, apex paraspinal muscle

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