Paraspinal muscle fibre type alterations associated with scoliosis: an old problem revisited with new evidence.
Paraspinal muscle fibre type alterations associated with scoliosis: an old problem revisited with new evidence.
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DOI：
10.1007/s005860050077
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发表时间：
1998-01-01
期刊：
影响因子：
--
通讯作者：
Muntener, M
中科院分区：
文献类型：
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作者：
Mannion, A F;Meier, M;Muntener, M
为了确定脊柱旁肌肉在特发性脊柱侧凸中受影响的程度，必须将患者的样本与性别和年龄相似的对照组进行比较。迄今为止，用于这些目的的控制数据不足。本研究的目的是重新排列该组织，以确定侧凸曲线顶点的一侧是否比另一侧表现出更大的肌肉异常。术中从14例女性脊柱侧凸患者的T9-T11侧凸曲线顶点处获得双侧棘旁肌肉样本。9名女性志愿者在T10脊柱左侧获得经皮肌肉活检样本。制备样品进行常规组织化学鉴定肌纤维类型。使用计算机图像分析来测量纤维的大小。与对照肌肉相比，侧凸曲线凹侧肌肉中I型（慢缩氧化）纤维的比例显著降低，而凸侧肌肉中I型（慢缩氧化）纤维的比例无差异。与对照组相比，IIB型（快速抽搐、糖酵解）纤维在曲线两侧的比例更高，在凹侧的效果更为明显。IIA型（慢收缩、氧化-糖酵解）纤维的百分比在两组之间没有差异，纤维的大小也没有差异（尽管对照组的IIA型纤维有比患者大的趋势）。总的来说，纤维类型大小和分布的差异意味着，与对照组相比，在凹侧，I型纤维占据的肌肉相对面积较小，而在曲线两侧，IIB型纤维占据的相对面积较大，IIA型纤维占据的相对面积较小。在脊柱侧凸中，脊柱肌肉组织在弯曲顶点的凹侧受影响最大。肌肉呈现“更快”或更多的“糖酵解”特征，这可能与肌肉低水平强直活动的减少相一致，这可能是由于脊柱这一侧的活动随着弯曲的进展而发生局部变化。在同一方向上，凸侧的变化也不太明显；这可能是与脊柱畸形相关的脊柱旁肌肉普遍失用的结果。
To establish the extent to which the paraspinal muscles are affected in idiopathic scoliosis, samples from patients must be compared with controls of a similar gender and age. To date, insufficient control data has been available for these purposes. The aim of this study was to re-dress this tissue, in order to identify whether one side of the apex of the scoliotic curve showed greater muscular abnormalities than the other. Bilateral samples of the paraspinal muscles were obtained during surgery from 14 female scoliosis patients, at the apex of the scoliotic curve at T9-T11. Percutaneous muscle biopsy samples were obtained from nine female volunteers, on the left side of the spine at T10. Samples were prepared for routine histochemistry for the identification of muscle fibre types. Fibre size was measured using computerised image analysis. Compared with control muscle, there was a significantly lower proportion of type I (slow-twitch oxidative) fibres in the muscle on the concave side of the scoliotic curve, but no difference on the convex side. The proportion of type IIB (fast-twitch, glycolytic) fibres was higher on both sides of the curve compared with controls, with the effect being significantly more marked on the concave side. The percentage of type IIA (slow-twitch, oxidative-glycolytic) fibres did not differ between the groups, and neither did fibre size (although there was a tendency for the controls to have larger type IIA fibres than the patients). Collectively, the differences in fibre type size and distribution meant that on the concave side the relative area of the muscle occupied by type I fibres was smaller, and on both sides of the curve the relative area occupied by type IIB fibres was greater and by type IIA fibres smaller, in comparison with controls. In scoliosis, the spinal musculature is most affected on the concave side of the curve's apex. The muscle adopts a 'faster', or more 'glycolytic' profile, which would be consistent with a reduced low-level tonic activity of the muscle, perhaps consequent to a local change in activity on this side of the spine following progression of the curve. Less marked changes, in the same direction, are also evident on the convex side; these may be the result of general disuse of the paraspinal muscles associated with the spinal deformity.