Department of Orthopaedics and Traumatology, Liv Hospital Ulus Istanbul, Istanbul, Turkey.
Department of Orthopaedics and Traumatology, Istinye University, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2023 Sep;57(5):271-276. doi: 10.5152/j.aott.2023.23099.
This study aimed to investigate the effect of osteosarcopenia on second fracture development and mortality in patients aged above 60 years undergoing vertebroplasty because of osteoporotic vertebral compression fracture (OVCF).
A retrospective evaluation was conducted on 104 patients treated by vertebroplasty because of OVF between 2016 and 2021. The L3 vertebra Hounsfield unit values and the psoas muscle index (PMI) values measured at the L3 vertebra level were obtained from the patients' medical data and computed tomography images. Using these measurements, the patients were divided into 3 groups: only osteoporosis (OO group), only sarcopenia (OS group), and osteosarcopenia (OSP group). Differences between the groups were evaluated regarding second OVCF development and mortality.
The study included 104 patients, comprising 30 males and 74 females aged 60-92 years. The OS group included 10 patients, the OO group included 54 patients, and the OSP group consisted of 40 patients. A single vertebral fracture occurred in 72 patients, and 2 vertebral fractures occurred in 32 patients. The chi-square test, Mann-Whitney U-test, Kruskal-Wallis test, and Kaplan-Meier survival analysis results showed no statistically significant difference between the 3 groups for the risk of second vertebral fracture. Sarcopenia, either alone or in combination with osteoporosis, was seen to have a negative effect on the survival of patients who underwent vertebro- plasty following a vertebral fracture.
This study has shown that osteosarcopenia did not increase the risk of developing a second vertebral fracture, but it increased mortality 2.8-fold for those who underwent vertebroplasty after vertebral fracture.
Level III, Prognostic study.
本研究旨在探讨骨质疏松性椎体压缩骨折（OVCF）患者行椎体成形术后发生第二处骨折和死亡的风险与骨-肌减少症的关系。
回顾性分析 2016 年至 2021 年间因 OVCF 行椎体成形术的 104 例患者的临床资料。通过患者的医学数据和 CT 图像获得 L3 椎体的 Hounsfield 单位值和 L3 椎体水平的竖脊肌指数（PMI）值。根据这些测量值，将患者分为 3 组：单纯骨质疏松（OO 组）、单纯肌减少症（OS 组）和骨-肌减少症（OSP 组）。比较各组患者第二处 OVCF 发生和死亡的差异。
本研究共纳入 104 例患者，其中男 30 例，女 74 例，年龄 60-92 岁。OS 组 10 例，OO 组 54 例，OSP 组 40 例。72 例患者发生单发椎体骨折，32 例患者发生 2 处椎体骨折。χ2 检验、Mann-Whitney U 检验、Kruskal-Wallis 检验和 Kaplan-Meier 生存分析结果显示，3 组患者第二处椎体骨折的风险无统计学差异。椎体骨折后行椎体成形术的患者中，单纯肌减少症或合并骨质疏松均会降低患者的生存率。
本研究表明，骨-肌减少症不会增加发生第二处椎体骨折的风险，但会使椎体骨折后行椎体成形术的患者死亡风险增加 2.8 倍。
III 级，预后研究。
