Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
The School of Health, Fujian Medical University, Fuzhou, Fujian, China.
Front Endocrinol (Lausanne). 2023 Jan 4;13:1073013. doi: 10.3389/fendo.2022.1073013. eCollection 2022.
Recently, the effects of paraspinal muscle degeneration on osteoporotic vertebral fractures (OVFs) have attracted the attention of researchers; however, studies are limited, and their results vary. Hence, this study aimed to determine the role of paraspinal muscle degeneration in the occurrence and recurrence of OVF.
Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline, the PubMed, Embase, Web of Science, Wanfang Data, China National Knowledge Infrastructure, and ClinicalTrials.gov databases were comprehensively searched for relevant studies. Studies comparing the cross-sectional area (CSA) or fatty infiltration (FI) of the paraspinal muscles (including the psoas (PS), erector spinae plus multifidus (ES+MF), quadratus lumborum) in patients with and without initial OVF, or with and without recurrent OVF were included and analyzed.
Eleven studies were included in the meta-analysis. Seven studies investigated the effects of paraspinal muscles on initial OVF, and the overall results revealed significantly lower CSA (SMD: -0.575, 95% CI: -0.866 to -0.285) and CSA (SMD: -0.750, 95% CI: -1.274 to -0.226), and higher FI (SMD: 0.768, 95% CI: 0.475 to 1.062) in the fracture group. Meanwhile, four studies evaluated the effects of the paraspinal muscles on recurrent OVF, and the pooled results demonstrated significantly higher FI (SMD:0.720, 95% CI: 0.258 to 1.182) in the refracture group, although no significant difference in CSA (SMD: -0.103, 95% CI: -0.395 to 0.189) was observed between the two groups.
Paraspinal muscle degeneration plays a role in the occurrence and recurrence of OVF. Assessing the paraspinal muscles may be useful for identifying high-risk populations.
https://www.crd.york.ac.uk/prospero/, identifier (CRD42021276681).
最近，腰背肌退化对骨质疏松性椎体骨折（OVF）的影响引起了研究人员的关注；然而，相关研究有限，结果也存在差异。因此，本研究旨在确定腰背肌退化在 OVF 的发生和复发中的作用。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，全面检索 PubMed、Embase、Web of Science、万方数据、中国知识基础设施和 ClinicalTrials.gov 数据库，以查找比较初始 OVF 患者与无 OVF 患者、初次 OVF 患者与复发 OVF 患者的腰背肌（包括腰大肌、竖脊肌加多裂肌、腰方肌）横截面积（CSA）或脂肪浸润（FI）的研究。
11 项研究纳入荟萃分析。7 项研究探讨了腰背肌对初始 OVF 的影响，总体结果显示，骨折组 CSA 显著降低（SMD：-0.575，95%CI：-0.866 至-0.285）和 CSA（SMD：-0.750，95%CI：-1.274 至-0.226），FI 升高（SMD：0.768，95%CI：0.475 至 1.062）。同时，4 项研究评估了腰背肌对 OVF 复发的影响，结果表明，再骨折组 FI 显著升高（SMD：0.720，95%CI：0.258 至 1.182），但两组 CSA 无显著差异（SMD：-0.103，95%CI：-0.395 至 0.189）。
腰背肌退化在 OVF 的发生和复发中起作用。评估腰背肌可能有助于识别高危人群。
