Ultrasound evaluation of the combined effects of thoracolumbar fascia injury and movement restriction in a porcine model

The persistence of back pain following acute back “sprains” is a serious public health problem with poorly understood pathophysiology. The recent finding that human subjects with chronic low back pain (LBP) have increased thickness and decreased mobility of the thoracolumbar fascia measured with ultrasound suggest that the fasciae of the back may be involved in LBP pathophysiology. This study used a porcine model to test the hypothesis that similar ultrasound findings can be produced experimentally in a porcine model by combining a local injury of fascia with movement restriction using a “hobble” device linking one foot to a chest harness for 8 weeks. Ultrasound measurements of thoracolumbar fascia thickness and shear plane mobility (shear strain) during passive hip flexion were made at the 8 week time point on the non-intervention side (injury and/or hobble). Injury alone caused both an increase in fascia thickness (p = .007) and a decrease in fascia shear strain on the non-injured sid...急性腰扭伤后腰痛迁延不愈是一个病因病理机制尚未明确的严重公共卫生问题。近期研究发现，慢性下腰痛（chronic low back pain, LBP）患者的胸腰筋膜（thoracolumbar fascia）经超声检测显示厚度增加、活动度降低，这提示背部筋膜可能参与了LBP的病理生理过程。本研究采用猪模型（porcine model），旨在验证下述假说：通过将筋膜局部损伤与使用"束缚绑具（hobble device）"限制活动相结合——该绑具将单足与胸带相连，持续8周——可在猪模型中实验性复制出类似的超声检测异常结果。在干预后第8周，研究人员于非干预侧（存在损伤和/或接受束缚处理）对胸腰筋膜厚度以及被动髋关节屈曲时的剪切面活动度（剪切应变，shear strain）进行了超声测量。仅施加损伤即可导致非损伤侧筋膜厚度增加（p=0.007），同时使其剪切应变降低……