Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, People's Republic of China.
Clin Interv Aging. 2022 Aug 13;17:1237-1248. doi: 10.2147/CIA.S374857. eCollection 2022.
The paraspinal muscle is essential for maintaining normal spine function and structure, which degeneration is closely related to various spinal diseases. The main objective of this study was to identify the potential role of paraspinal muscle degeneration in the occurrence of new vertebral compression fractures (NVCF) and develop a clinically applicable nomogram for prospective NVCF risk prediction.
A total of 202 patients with single-level osteoporotic vertebral compression fractures (OVCF) who underwent percutaneous kyphoplasty treatment between January 2016 and March 2019 were included in this study. Demographic, clinical, radiological, and treatment data were collected and analyzed. The paraspinal muscle cross-sectional area (CSA) and fat signal fraction (FSF) were measured to quantify the extent of muscle degeneration. Multivariate binary logistic regression analysis was performed to select risk factors to build a nomogram that predicted the occurrence of NVCF. The concordance index (C-index) and calibration curve were used to evaluate the discriminative capacity and predictive accuracy of the nomogram.
NVCF occurred in 54 of 202 patients (26.7%). The erector spinae FSF (OR = 1.064; P = 0.001), psoas major FSF (OR = 1.326; P < 0.001), and the difference index of the muscle CSA between multifidus and psoas major (OR = 1.048; P < 0.001) were independent risk factors for the occurrence of NVCF. The nomogram performance was good after evaluation using the calibration curves and C-index (95% confidence interval, 0.854-0.943).
Paraspinal muscle degeneration is a potential risk factor for NVCF occurrence. A nomogram was designed to precisely predict the risk of NVCF. This predictive nomogram may help clinicians to make better clinical decisions and provide more accurate functional exercise protocol for OVCF patients.
脊柱旁肌肉对于维持正常脊柱功能和结构至关重要，其退化与各种脊柱疾病密切相关。本研究的主要目的是确定脊柱旁肌肉退化在新发椎体压缩性骨折（NVCF）发生中的潜在作用，并开发一种用于预测 NVCF 风险的临床适用诺模图。
本研究纳入了 2016 年 1 月至 2019 年 3 月期间接受经皮椎体后凸成形术治疗的 202 例单节段骨质疏松性椎体压缩性骨折（OVCF）患者。收集并分析了患者的人口统计学、临床、影像学和治疗数据。测量脊柱旁肌肉横截面积（CSA）和脂肪信号分数（FSF）来量化肌肉退化程度。采用多变量二项逻辑回归分析选择风险因素来构建预测 NVCF 发生的诺模图。采用一致性指数（C-index）和校准曲线评估诺模图的区分能力和预测准确性。
在 202 例患者中，有 54 例（26.7%）发生了 NVCF。竖脊肌 FSF（OR=1.064；P=0.001）、腰大肌 FSF（OR=1.326；P<0.001）和多裂肌与腰大肌 CSA 差值指数（OR=1.048；P<0.001）是 NVCF 发生的独立危险因素。通过校准曲线和 C 指数（95%置信区间，0.854-0.943）评估，该诺模图的性能良好。
脊柱旁肌肉退化是 NVCF 发生的潜在危险因素。本研究设计了一个诺模图来准确预测 NVCF 的风险。该预测诺模图可能有助于临床医生做出更好的临床决策，并为 OVCF 患者提供更准确的功能锻炼方案。
