2024, Vol. 28 ›› Issue (33): 5315-5319

Osteoporotic vertebral compression fracture predicted by functional cross-sectional area of paravertebral muscles

Zhang Wensheng1, 2, Song Zhenjie1, 2, Guo Haiwei1, 2, Wu Chunfei1, 2, Yang Handi1, 2, Li Ying1, 2, Li Wenchao1, 2, Liu Hongjiang1, 2, Yang Xiaoguang1, 2, Yuan Chao1, 2   

Abstract: BACKGROUND: Osteoporosis vertebral compression fracture is a common fracture secondary to osteoporosis, and there is currently a lack of effective predictive indicators and methods for osteoporosis vertebral compression fracture.
OBJECTIVE: To investigate the predictive effects of paravertebral muscle degeneration, functional cross-sectional area, and percentage of fat infiltration on osteoporotic vertebral compression fractures.
METHODS: The 224 patients with osteoporosis diagnosed from January 2018 to June 2022 were included. They were followed up for more than 2 years. They were divided into fracture group and non-fracture group according to the presence and absence of vertebral fracture. The detailed information of demographics, body mass index, bone mineral density and so on were collected. The functional cross-sectional area and percentage of fat infiltration of bilateral Psoas major muscle and extensor dorsi (Erector spinae muscles muscle and multifidus muscle) at the level of lower endplate of L2 vertebral body were measured and calculated.
RESULTS AND CONCLUSION: (1) 224 patients were ultimately included, of which 126 had fractures as the fracture group and 98 had no fractures as the non-fracture group. There was no statistically significant difference in age, gender, height, body mass, body mass index, and fracture segment between the two groups (P > 0.05). (2) The bone mineral density of the fracture group was significantly lower than that of the non-fracture group (P < 0.05). Functional cross-sectional areas of Psoas major muscle and extensor dorsi in the fracture group were significantly lower than those in the non-fracture group (P < 0.05). The percentage of fat infiltration of the extensor dorsi in the fracture group was significantly higher than that in the non-fracture group (P < 0.05). There was no significant difference in percentage of fat infiltration of Psoas major muscle between the two groups (P > 0.05). (3) Receiver operating characteristic analysis showed that the vertebral bone mineral density, percentage of fat infiltration of extensor dorsi, functional cross-sectional area of extensor dorsi and percentage of fat infiltration of Psoas major muscle were 0.903 g/cm2, 35.426%, 418.875 mm2, and 6.375%, respectively. The areas under curve were 0.634, 0.755, 0.876, and 0.585, respectively. (4) These findings indicate that paravertebral muscle degeneration is strongly associated with the occurrence of osteoporotic vertebral compression fractures. The functional cross-sectional area of extensor dorsi muscle can effectively predict the occurrence of osteoporotic vertebral compression fractures, which is helpful for early prevention and treatment of osteoporotic vertebral compression fractures.

Key words: paravertebral muscle, functional cross-sectional area, osteoporosis, lumbar spine fracture, prediction