Establishment and application of paravertebral muscle endurance and left-right symmetry measurement indexes and methods in teenagers / 中国组织工程研究

BACKGROUND: Surface electromyography has Indicated that non-specific chronic low back pain patients have Inconsistent changes in the motion of erector spinae muscles on both sides of the lumbar spine. Existing physical fitness evaluation focuses on the evaluation of the overall strength of the waist, whereas there is no report on the evaluation methods and indicators of paravertebral muscle in teenagers. OBJECTIVE: To establish methods and indicators for assessing teenagers' paravertebral muscle endurance and left-right symmetry, and to preliminarily formulate evaluation criteria. METHODS: Two hundred students, aged 13-18 years, were randomly selected In a middle school of Beijing, half male and half female. There were 100 junior high school students and 100 high school students. All the subjects did Biering-Sorensen (B-S) exercise to maintain Isometric contraction of paravertebral muscles, and surface electromyography was then used to record the electromyography of bilateral erector spine muscles (ES) of L3-L4 and multifidus muscles (MF) of L5-S 0. 05, and correlation coefficient within the group was ICC > 0. 80 (P < 0. 01), indicating a good repeatability. Fitting composite Index, the Index v=slopeMPF (LES+RES+LMF+RMF)/4 was used to evaluate teenagers' paravertebral muscular endurance, and u=slopeMPF (LES-RES)/slopeMPF (LES+RES)+slopeMPF (LMF-RMF)/slopeMPF (LMF+RMF) was to evaluate the left-right symmetry. The evaluation results revealed that the paravertebral muscle endurance of high school students of the same sex was Increased In relative to junior high school students (P < 0. 01). There were significant differences in paravertebral muscle endurance between male and female students In high school. The teenagers' paravertebral muscle endurance and symmetry showed normal distribution, and could be graded by deviation method. In this study, the Indexes and methods for evaluating paravertebral muscle endurance and left-right symmetry were preliminarily established, and the criteria for evaluating juvenile paravertebral muscle endurance and left-right symmetry were preliminarily established by deviation method.

Design of Paravertebral Muscle Monitoring System Based on Surface Electromyography / 中国医疗器械杂志

In order to diagnose and evaluate the human spinal lesions through the paravertebral muscles, a paravertebral muscle monitoring system based on surface EMG signals was designed. The system used surface mount electrodes to obtain the surface myoelectric signal (sEMG) of paravertebral muscle. The signal was filtered and amplified by the conditioning circuit. The signal was collected by the microcontroller NRF52832 and was sent to the mobile APP. After the signal was preprocessed by the wavelet threshold denoising algorithm in APP, the time and frequency characteristics of the sEMG signal reflecting the functional state of the muscle were extracted. The calculated characteristic parameters was displayed in real time in the application interface. The experimental results show that the system meets the design requirements in analog signal acquisition, digital processing of signals and calculation of characteristic parameters. The system has certain application value.

Relationship of the Pre-operative Condition of Paravertebral Muscle with Post-operative Functional Disability in Patients with Degenerative Lumbar Spinal Disease

STUDY DESIGN: A retrospective study on the outcomes of surgical treatment for degenerative lumbar spinal disease. OBJECTIVES: To evaluate the pre-operative paravertebral muscle condition as a predictive factor in patients with degenerative lumbar spinal disease who undergo surgery. SUMMARY OF LITERATURE REVIEW: Previous studies have reported that the atrophy of the paravertebral muscle is associated with chronic low back pain. However, few studies have reported on the relationship of the pre-operative paravertebral muscle status with the postoperative functional disability scale. MATERIALS AND METHODS: In this study, we reviewed the history of 20 patients with degenerative lumbar spinal disease treated by decompression and posterior lumbar interbody fusion with posterior instrumentation between 2010 and 2011. The evaluation included the paravertebral muscle volume, fat infiltration on magnetic resonance imaging (MRI), preoperative lumbar lordosis, levels operated on, and the Oswestry Disability Index (ODI). Further, the inter-relationship of the pre-operative paravertebral muscle status, lumbar lordosis, and levels operated on with the post-operative ODI was analyzed. RESULTS: The mean cross-sectional area (CSA) of the paravertebral muscle at the L3-4 and L4-5 levels was 21.9+/-3.4 cm2 and 21.4+/-3.3 cm2, respectively. The mean pre- and post-operative lumbar lordotic angle was 41.0+/-17.5degrees, and 42.3+/-11.1degrees, respectively. The lumbar lordotic angle and the levels operated on were not correlated with the post-operative ODI. However, the CSA of the paravertebral muscle at the L3-4 (r=-0.582, p<0.01) and L4-5 (r=-0.568, p<0.01) levels showed a negative correlation with the post-operative ODI. The levels operated on showed a positive correlation with the post-operative ODI (r=0.420, p<0.01). CONCLUSIONS: The mean CSA of the paravertebral muscle and the levels operated on in patients with degenerative lumbar spinal disease have a significant correlation with the post-operative clinical outcome.

Mini Open Foraminotomy for Cervical Radiculopathy: A Comparison of Large Tubular and TrimLine Retractors

STUDY DESIGN: Retrospective chart review. PURPOSE: A comparison of mini open foraminotomy (MOF) for cervical radiculopathy using either large tubular (LT) or TrimLine (TL) retractors. OVERVIEW OF LITERATURE: Posterior foraminotomy relieves compression of the cervical nerve root in radiculopathy patients. However, invasion of the paravertebral muscle may cause major problems in these patients. To address these problems, we performed MOF. METHODS: Twenty cervical radiculopathy patients (16 male and 4 female) who underwent MOF between May 2004 and August 2011 were assigned to LT and TL groups. Each group contained 10 subjects. Surgical and clinical outcomes were compared. RESULTS: The average operating time in the TL group was significantly shorter than that in the LT group. The final follow-up mean neck disability indices significantly improved compared to the preoperative values (LT group, 12.0+/-7.8 vs. 28.0+/-9.4; TL group, 6.0+/-5.9 vs. 21.9+/-10). The final follow-up neck pain visual analog scale (VAS) scores also decreased significantly from the preoperative of 8.0+/-1.5 and 2.5+/-2.5 to the final follow-up values of 2.2+/-2.2 and 1.0+/-2.5 in the LT and TL groups, respectively. The recovery rate for the neck pain VAS score was 70.0+/-31.9 in the LT group and 87.0+/-32.0 in the TL group, thus suggesting no significant difference between the two groups. CONCLUSIONS: MOF with the TL retractor is an easy and safe procedure. Furthermore, the use of the TL retractor allows for a minimally invasive and effective surgical treatment of cervical radiculopathy patients.

The curative effect of two methods of surgical treatment for thoracolumbar fractures / 重庆医学

Objective To investigate the curative effects of the traditional surgical method of posterior pedicle Schanz screw fixa-tion with partially stripping injured paravertebral muscle in treating thoracolumbar fracture .Methods 52 cases with thoracolumbar fracture underwent posterior pedicle Schanz screw fixation to partially strip injured paravertebral muscle from January ,2010 to Jan-uary ,2012 .The patients were divided into partially stripping injured paravertebral muscle group (32 cases) and traditionally strip-ping injured paravertebral muscle group(20 cases) .The blood loss ,postoperative drainage ,kyphosis postoperative 3 d VAS scores , vertebral height correction rate ,Cobb angle correction ,Oswestry dysfunction indexes were copmared .Results Comparing with tra-ditionally stripping injured paravertebral muscle group ,the partially stripping injured paravertebral muscle group has better effect in transperative blood loss ,postoperative drainage and postoperative 3 d VAS scores ,the differences were statistically significant .But there was no statistical significance between the two groups in vertebral height correction rate ,kyphosis Cobb angle correction ,Os-westry dysfunction indexes .Conclusion Partially strip injured paravertebral muscle has less painful than traditional surgery does , being safe and effective with small invasion and easy to recover .

Comparison of Spinous Process-Splitting Laminectomy versus Conventional Laminectomy for Lumbar Spinal Stenosis

STUDY DESIGN: Seventy-five patients who had been treated for lumbar spinal stenosis (LSS) were reviewed retrospectively. PURPOSE: Invasion into the paravertebral muscle can cause major problems after laminectomy for LSS. To address these problems, we performed spinous process-splitting laminectomy. We present a comparative study of decompression of LSS using 2 approaches. OVERVIEW OF LITERATURE: There are no other study has investigated the lumbar spinal instability after spinous process-splitting laminectomy. METHODS: This study included 75 patients who underwent laminectomy for the treatment of LSS and who were observed through follow-ups for more than 2 years. Fifty-five patients underwent spinous process-splitting laminectomy (splitting group) and 20 patients underwent conventional laminectomy (conventional group). We evaluated the clinical and radiographic results of each surgical procedure. RESULTS: Japanese Orthopaedic Association score improved significantly in both groups two years postoperatively. The following values were all significantly lower, as shown with p-values, in the splitting group compared to the conventional group: average operating time (p=0.002), postoperative C-reactive protein level (p=0.006), the mean postoperative number of days until returning to normal body temperature (p=0.047), and the mean change in angulation 2 years postoperatively (p=0.007). The adjacent segment degeneration occurred in 6 patients (10.9%) in the splitting group and 11 patients (55.0%) in the conventional group. CONCLUSIONS: In this study, the spinous process-splitting laminectomy was shown to be less invasive and more stable for patients with LSS, compared to the conventional laminectomy.

Non-Traumatic Myositis Ossificans in the Lumbosacral Paravertebral Muscle

Myositis ossificans (MO) is a benign condition of non-neoplastic heterotopic bone formation in the muscle or soft tissue. Trauma plays a role in the development of MO, thus, non-traumatic MO is very rare. Although MO may occur anywhere in the body, it is rarely seen in the lumbosacral paravertebral muscle (PVM). Herein, we report a case of non-traumatic MO in the lumbosacral PVM. A 42-year-old man with no history of trauma was referred to our hospital for pain in the low back, left buttock, and left thigh. On physical examination, a slightly tender, hard, and fixed mass was palpated in the left lumbosacral PVM. Computed tomography showed a calcified mass within the left lumbosacral PVM. Magnetic resonance imaging (MRI) showed heterogeneous high signal intensity in T1- and T2-weighted image, and no enhancement of the mass was found in the postcontrast T1-weighted MRI. The lack of typical imaging features required an open biopsy, and MO was confirmed. MO should be considered in the differential diagnosis when the imaging findings show a mass involving PVM. When it is difficult to distinguish MO from soft tissue or bone malignancy by radiology, it is necessary to perform a biopsy to confirm the diagnosis.

High Grade Myxofibrosarcoma in the Paravertebral Muscle: A Case Report

Many different abnormalities, such as, neoplasm, infection, traumatic hematoma, or congenital or immune myopathy, may be found in the paravertebral muscles. However, neoplasms of paravertebral muscle are an uncommon cause of back pain. Such neoplasms may arise from local lesions or due to metastatic spread from a distant malignancy. The differential diagnoses of a primary soft tissue malignancy and metastatic spread from a skeletal muscle tumor are important. In cases of soft tissue sarcoma, histopathological findings and surgical margins are both related to local recurrence and metastasis, therefore, percutaneous needle biopsy may be helpful before surgical excision. A degree of surgical excision is decided based on considerations of muscular function and histopathological findings.

Comparative Study of Paravertebral Muscles in Congenital Scoliosis and Idiopathic Scoliosis Patients / 中国康复理论与实践

@#Objective To identify the role of paravertebral muscles in the pathogenesis of scoliosis.MethodsParavertebral muscles were gotten from the 37 patients(12 congenital scoliosis patients and 25 idiopathic scoliosis patients) during the operations.Cryostat sections were cut by 10 μm nd stained with H&E,m-GT,NADH-TR,ATPase.ResultsMyogenic changes,incuding muscle fibrosis,fiber necrosis,etc,were common in paravertebral muscles of scoliosis patients,however regenerating fibers were quite rare.Diffuse fibrosis and remarkablely disorganized fiber directions presented in most of congenital scoliosis patients,while focal fibrosis without necrosis in most of idiopathic scoliosis patients.Neurogenic changes were found in one congenital scoliosis patient and 4 idiopathic scoliosis patients,however four of the five patients had undergone orthopedics.Thickened capsule wall of muscle spindles and connective tissue infiltration in muscle spindles were found in both kinds of scoliosis.ConclusionThere are some differences on pathological changes of paravertebral muscles between congenital scoliosis and idiopathic scoliosis,which indicates that paravertebral muscles may play a special role in the pathogenesis of idiopathic scoliosis.

Comparative Study of Paravertebral Muscles in Congenital Scoliosis and Idiopathic Scoliosis Patients / 中国康复理论与实践

@#Objective To identify the role of paravertebral muscles in the pathogenesis of scoliosis.MethodsParavertebral muscles were gotten from the 37 patients(12 congenital scoliosis patients and 25 idiopathic scoliosis patients) during the operations.Cryostat sections were cut by 10 μm nd stained with H&E,m-GT,NADH-TR,ATPase.ResultsMyogenic changes,incuding muscle fibrosis,fiber necrosis,etc,were common in paravertebral muscles of scoliosis patients,however regenerating fibers were quite rare.Diffuse fibrosis and remarkablely disorganized fiber directions presented in most of congenital scoliosis patients,while focal fibrosis without necrosis in most of idiopathic scoliosis patients.Neurogenic changes were found in one congenital scoliosis patient and 4 idiopathic scoliosis patients,however four of the five patients had undergone orthopedics.Thickened capsule wall of muscle spindles and connective tissue infiltration in muscle spindles were found in both kinds of scoliosis.ConclusionThere are some differences on pathological changes of paravertebral muscles between congenital scoliosis and idiopathic scoliosis,which indicates that paravertebral muscles may play a special role in the pathogenesis of idiopathic scoliosis.