【論文摘要】Comparing Cross-Sectional Area of Psoas Major in Patients With Degenerative Lumbar Spine to Asymptomatic Participants Using Different Parameters

【論文摘要】不同參數之腰大肌橫截面積於退化性腰椎病人與無症狀者的差別

王奕棋(Yi-Chi Wang) ； 蔣昕恬(Shing-Tian Chiang) ； 瞿琰(Yean Chu) ； 郭鎮宇(Jen-Yu Guo) ； 賴達明(Dar-Ming Lai) ； 王淑芬(Shwu-Fen Wang)

《物理治療》 47卷2期 (2022/06) Pp. 159-160

https://doi.org/10.6215/FJPT.202206.P51

摘要

Background and Purpose: The psoas major (PM) is important for stabilizing lumbopelvic region and providing strength of limb during functional activity. Changes of cross-sectional area (CSA) of PM have been suggested in patients with low back pain. Previously, the CSA value of PM has been processed by minus fat infiltration; dividing by body mass index (BMI), square of height, vertebral body (VB) or intervertebral disc area. However, there is no clear consensus on how to properly process CSA to facilitate comparison between groups. We aim to review and compare the methods for analyzing muscle CSA and to identify which methods could reveal the difference between groups. Methods: Five men and three women with lumbar degenerative spondylolisthesis and stenosis (LDSS) and their age-, gender, weight-, and height-matched controls were included. 3T-MRI was used to scan the lumbar regions, and the CSA values of PM at L3/4 level (CSAp), the fat infiltration area, and disc area was measured by ImageJ software. The CSAp were further processed by subtraction of fatty infiltration area (CSAp-), by dividing by disc area (CSAp-/D), BMI (CSAp-/BMI), or square of height (CSAp-/H^2). These different parameters (CSAp-, CSAp-/D, CSAp-/BMI, CSAp-/ H^2) between groups were statistically analyzed by student's t test. Results: CSAp- of patient (10.02 ± 3.68 cm^2) and asymptomatic participants (6.66 ± 2.40) was significantly different (p = 0.0353); CSAp-/H^2 of patient (3.63 ± 1.25) and asymptomatic participants (2.35 ± 1.08) was also significantly different (p = 0.0160). However, CSAp-/D of patient (0.63 ± 0.21) and asymptomatic participants (0.44 ± 0.13) was not significantly different (p = 0.0605), and CSAp-/BMI of patient (0.39 ± 0.12) and asymptomatic participants (0.28 ± 0.12) was not significantly different (p = 0.0514), either. Conclusions: CSAp- could reveal the significant differences between groups in our study. Larger sample size might be required to obtain significance with CSAp-/D and CSAp-/BMI. Clinical Relevance: Assessment of PM, as well as fat infiltration, in patients with spinal degenerative disease is supported by this finding.