Fatty infiltration in the cervical extensor muscles in persistent whiplash-associated disorders - A magnetic resonance imaging analysis
Fatty infiltration in the cervical extensor muscles in persistent whiplash-associated disorders - A magnetic resonance imaging analysis
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DOI：
10.1097/01.brs.0000240841.07050.34
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发表时间：
2006-10-15
期刊：
影响因子：
3
通讯作者：
Gibbon, Wayne W.
中科院分区：
文献类型：
--
作者：
Elliott, James;Jull, Gwendolen;Gibbon, Wayne W.
研究设计。持续性鞭打相关疾病(WAD)患者肌肉变化的横断面调查。目的：定量比较慢性鞭打患者(WAD II)和健康对照受试者在肌肉和颈部节段水平上颈伸肌脂肪浸润物的存在。磁共振成像(MRI)可以作为肌肉成像的金标准；然而，对于持续性WAD患者颈伸肌的活体特征，以及肌肉、椎节、年龄、自报疼痛和残疾、代偿状态、体重指数和症状持续时间等因素，脂肪含量如何变化的了解很少。对113例女性(79例肥胖，34例健康对照；18~45岁，伤后3个月~3年)双侧颈伸肌脂肪渗出进行了可靠的MRI测量。所有受试者均测量头后小直肌、后大直肌、多裂肌、头颈半棘肌、头脾、上斜方肌。与健康对照组相比，WAD受试者所有颈伸肌的脂肪浸润量显著增加(均P<；0.0001)。此外，颈水平和肌肉的脂肪浸润量也不同，C3的小/大直肌和多裂肌脂肪浸润量最大(P<；0.0001)。肌内脂肪与年龄、自我报告的疼痛/残疾、代偿状态、体重指数和症状持续时间无关。与健康对照组相比，持续性肥胖症患者颈伸肌，尤其是上颈椎深层肌肉中的脂肪渗透明显增加。需要进一步的研究来调查肌肉改变与持续性WAD患者症状之间的关系。
Study Design. Cross-sectional investigation of muscle changes in patients suffering from persistent whiplash-associated disorders (WAD).Objectives. To quantitatively compare the presence of fatty infiltrate in the cervical extensor musculature in a cohort of chronic whiplash patients (WAD II) and healthy control subjects across muscle and cervical segmental level.Summary of Background Data. Magnetic resonance imaging (MRI) can be regarded as the gold standard for muscle imaging; however, there is little knowledge about in vivo features of neck extensor muscles in patients suffering from persistent WAD and how fat content alters across the factors of muscle, vertebral segments, age, self- reported pain and disability, compensation status, body mass index, and duration of symptoms.Methods. A reliable MRI measure for fatty infiltrate was performed of the cervical extensor muscles bilaterally in 113 female subjects (79 WAD, 34 healthy control; 18-45 years, 3 months to 3 years post injury). The measure was performed on all subjects for the rectus capitis posterior minor and major, multifidus, semispinalis cervicis and capitis, splenius capitis, and upper trapezius.Results. The WAD subjects had significantly larger amounts of fatty infiltrate for all of the cervical extensor muscles compared with healthy control subjects (all P < 0.0001). In addition, the amount of fatty infiltrate varied by both cervical level and muscle, with the rectus capitis minor/ major and multifidi at C3 having the largest amount of fatty infiltrate (P < 0.0001). Intramuscular fat was independent of age, self- reported pain/ disability, compensation status, body mass index, and duration of symptoms.Conclusion. There is significantly greater fatty infiltration in the neck extensor muscles, especially in the deeper muscles in the upper cervical spine, in subjects with persistent WAD when compared with healthy controls. Future studies are required to investigate the relationships between muscular alterations and symptoms in patients suffering from persistent WAD.