摘要目的 观察退行性腰椎后凸畸形(LDK)患者手术前、后椎旁肌肉表面肌电(sEMG)信号特征.方法 共纳入符合临床诊断标准的LDK患者30例,均给予椎弓根减压截骨术治疗.于手术前、手术后3个月时分别采用sEMG技术评估患者椎旁肌肉肌电变化情况,分析患者弯腰抬物过程中椎旁肌平均肌电值(AEMG)及平均功率频率斜率(MPFs)变化,并与同龄健康人群(对照组)进行对比.结果 术前LDK组患者在静态站立时,其椎旁肌AEMG值明显高于对照组水平(P＜0.05),术后明显低于术前水平(P＜0.05),但仍显著高于对照组水平(P＜0.05).术前LDK组患者在躯干伸展时,其L12节段椎旁肌AEMG值明显低于对照组水平(P＜0.05),术后明显高于术前水平(P＜0.05),此时与对照组间差异无统计学意义(P＞0.05).术前LDK组L4-5节段椎旁肌AEMG值明显低于对照组水平(P＜0.05);术后较术前无明显变化(P＞0.05),仍显著低于对照组水平(P＜0.05).术前LDK组患者抬物保持阶段其椎旁肌MPFs值显著低于对照组(P＜0.05),术后显著高于术前水平,但仍显著低于对照组水平(P＜0.05).结论 LDK患者存在明显椎旁肌肉无力及严重疲劳,椎弓根减压截骨术可在短期内显著改善患者椎旁肌肉功能状态.

abstractsObjective To study any changes in the surface electromyography of the paraspinal muscles before and after surgery in patients with degenerative lumbar kyphosis.Methods Thirty patients with lumbar degenerative kyphosis (LDK) were enrolled and underwent pedicle subtraction osteotomy.Surface electromyograms were recorded before the operation and 3 months afterward to observe the myoelectric activity of the paraspinal muscles.The electromyograms were also compared with those of healthy counterparts.Results The preoperative average EMG (AEMG) values in the LDK group in static standing were significantly higher than those of the control group.After the operation the values had decreased significantly,but were still significantly higher than in the control group.The preoperative AEMG values of the LDK group from the L1-2 segment during torso stretching were significantly lower than those of the control group.They increased significantly after the operation and were no longer significantly different from the control groups' readings.The pre-and post-operative AEMG values from the L4-5 segment were not significantly different and remained significantly lower than in the control group.During lifting and holding the mean power frequency slopes of the LDK group were significantly lower than those of the controls both before and after the operation,though the postoperative slopes were significantly higher than the preoperative ones.Conclusion Patients with lumbar degenerative kyphosis have obvious paraspinal muscle weakness and severe fatigue.Early pedicle subtraction osteotomy can significantly improve the functional status of the paravertebral muscles in the short term.