Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, 04103, Leipzig, Germany.
Calcif Tissue Int. 2022 Apr;110(4):421-427. doi: 10.1007/s00223-021-00925-1. Epub 2021 Oct 15.
To assess the potential influence of multifidus atrophy and fatty degeneration on the incidence of adjacent vertebral compression fractures within one year after the index fracture. In a retrospective cohort study, patients who underwent surgery for an OVCF were identified and baseline characteristics, fracture patterns and the occurrence of secondary adjacent fractures within one year were obtained by chart review. Multifidus muscle atrophy and fatty degeneration were determined on preoperative MRI or CT scans. In this analysis of 191 patients (mean age 77 years, SD 8, 116 female), OF type 3 was the most common type of OVCF (49.2%). Symptomatic adjacent OVCFs within one year after index fracture were observed in 23/191 patients (12%) at mean 12, SD 12 weeks (range 1-42 weeks) postoperatively. The mean multifidus muscle area was 264, SD 53 mm in patients with an adjacent vertebral fracture and 271, SD 92 mm in patients without a secondary fracture (p = 0.755). Mean multifidus fatty infiltration was graded Goutallier 2.2, SD 0.6 in patients with an adjacent fracture and Goutallier 2.2, SD 0.7 in patients without an adjacent fracture (p = 0.694). Pre-existing medication with corticosteroids was associated with the occurrence of an adjacent fracture (p = 0.006). Multifidus area and multifidus fatty infiltration had no significant effect on the occurrence of adjacent vertebral fractures within one year after the index fracture. Patients with a pre-existing medication with corticosteroids were more likely to sustain an adjacent fracture.
评估多裂肌萎缩和脂肪变性对指数性骨折后 1 年内相邻椎体压缩性骨折发生率的潜在影响。在一项回顾性队列研究中，通过病历回顾确定了接受 OVCF 手术治疗的患者，并获取了基线特征、骨折类型以及术后 1 年内发生继发性相邻骨折的情况。通过术前 MRI 或 CT 扫描确定多裂肌萎缩和脂肪变性情况。在这项对 191 例患者（平均年龄 77 岁，标准差 8 岁，116 例女性）的分析中，OVCF 最常见的类型为 OF 型 3 型（49.2%）。在指数性骨折后 1 年内，191 例患者中有 23 例（12%）出现症状性相邻 OVCF，术后平均 12 周（范围 1-42 周）时出现症状。在发生相邻椎体骨折的患者中，多裂肌面积的平均值为 264，标准差为 53mm，在无继发性骨折的患者中为 271，标准差为 92mm（p=0.755）。在发生相邻骨折的患者中，多裂肌脂肪浸润的平均 Goutallier 分级为 2.2，标准差为 0.6，在无相邻骨折的患者中为 2.2，标准差为 0.7（p=0.694）。术前使用皮质类固醇与相邻骨折的发生相关（p=0.006）。多裂肌面积和多裂肌脂肪浸润对指数性骨折后 1 年内相邻椎体骨折的发生无显著影响。术前使用皮质类固醇的患者更有可能发生相邻骨折。
