Surface electromyographic analysis of paraspinal musculature in patients with single-level lumbar disc herniation with secondary lumbar scoliosis after disc removal

doi:10.3969/j.issn.2095-4344.2014.53.025

Abstract

Abstract:

BACKGROUND: Electromyographic analysis of the paraspinal musculature in patients with congenital and idiopathic scoliosis has been widely studied. Electromyographic analysis of paraspinal musculature strength has rarely been researched in patients with lumbar disc herniation and secondary lumbar scoliosis.
OBJECTIVE: To analyze electromyographic activity using surface-electromyogram technology and assess the strength of paraspinal musculature in patients with lumbar disc herniation and secondary lumbar scoliosis so as to reveal their unique clinical features, and to explore the pathogenetic mechanism of lumbar socliosis.
METHODS: A total of 26 adult patients with single-level lumbar disc herniation presenting secondary lumbar scoliosis were retrospectively analyzed from July 2012 to July 2014. Patients were subjected to percutaneous transforaminal endoscopic lumbar disc decompression surgery. Before and after treatment, patients accepted full spine anterior-posterior X-ray to measure lumbar Cobb angle and trunk shift distance. Special surface-electromyogram test was conducted to measure recruitment order so as to access the strength of paraspinal musculature.
RESULTS AND CONCLUSION: After treatment, lumbar scoliosis apparently reduced in all patients, and the balance of spine in coronal plane was restored. The average of lumbar Cobb angle was (11.81±3.50)° and (2.65±3.10)° before and after surgery, which was significantly improved (9.15±2.84)° (P < 0.05). The average of trunk shift distance was (5.92±3.20) and (0.32±0.26) cm before and after surgery, which was significantly different (5.59±3.08) cm (P < 0.05). Pain was significantly lessened after surgery (P < 0.05). The mean Oswestry Disability Index improved from 78% before surgery to 4% after surgery. On the level of the herniated disc, when bending to the concave side, the mean recruitment order of spinal musculature in the concave side of lumbar scoliosis was (0.21±0.12) mV and (0.88±0.26) mV after treatment; the improvement was (0.59±0.27) mV. In the convex side, when bending to the opposite side, the mean increase of recruitment order was (0.67±0.27) mV from (0.29±0.12) mV before surgery to (0.88±0.25) mV after surgery (P < 0.05). However, there was no significant difference between concave and convex sides of the recruitment order postoperatively (0.003±0.02) mV (P > 0.05). All patients were followed up more than one year. No severe complication was observed after percutaneous transforaminal endoscopic lumbar disc decompression. Above results suggest that lumbar scoliosis secondary to the lumbar disc herniation was a compensated presentation. Early decompression helps to spontaneously correct scoliosis. Spinal musculature plays an important role in keeping the spinal coronal balance.

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

全文链接：

Key words: lumbar vertebrae, intervertebral disk displacement, scoliosis, electrophysiology

CLC Number:

R318

Liang Chen, Sun Jian-min, Cui Xin-gang, Jiang Zhen-song, Zhang Wen . Surface electromyographic analysis of paraspinal musculature in patients with single-level lumbar disc herniation with secondary lumbar scoliosis after disc removal[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(53): 8661-8665.

Figures/Tables 2

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