School of Sports Medicine and Health, Chengdu Sport University, No.2, Tiyuan Road, Chengdu, Sichuan, China.
Department of radiology, Sichuan Province Orthopedic Hospital, No.132, West Section of 1st Ring Road, Chengdu, Sichuan, China.
BMC Musculoskelet Disord. 2024 May 7;25(1):360. doi: 10.1186/s12891-024-07484-0.
Increasing research suggests that paraspinal muscle fat infiltration may be a potential biological marker for the assessment of osteoporosis. Our aim was to investigate the relationship between lumbar paraspinal muscle properties on MRI and volumetric bone mineral density (vBMD) based on QCT in patients with lumbar disc herniation (LDH).
A total of 383 patients (aged 24-76 years, 193 females) with clinically and radiologically diagnosed LDH were enrolled in this retrospective study. The muscle cross-sectional area (CSA) and the proton density fat fraction (PDFF) were measured for the multifidus (MF), erector spinae (ES) and psoas major (PS) at the central level of L3/4, L4/5 and L5/S1 on lumbar MRI. QCT was used to measure the vBMD of two vertebral bodies at L1 and L2 levels. Patients were divided into three groups based on their vBMD values: normal bone density group (> 120 mg/cm), osteopenia group (80 to 120 mg/cm) and osteoporosis group (< 80 mg/cm). The differences in paraspinal muscle properties among three vBMD groups were tested by one-way ANOVA with post hoc analysis. The relationships between paraspinal muscle properties and vBMD were analyzed using Pearson correlation coefficients. Furthermore, the association between vBMD and paraspinal muscle properties was further evaluated using multiple linear regression analysis, with age and sex also included as predictors.
Among the 383 LDH patients, 191 had normal bone density, 129 had osteopenia and 63 had osteoporosis. In LDH patients, compared to normal and osteopenia group, paraspinal muscle PDFF was significantly greater in osteoporosis group, while paraspinal muscle CSA was lower (p < 0.001). After adjusting for age and sex, it was found that MF PDFF and PS CSA were found to be independent factors influencing vBMD (p < 0.05).
In patients with LDH, paraspinal muscle properties measured by IDEAL-IQ sequence and lumbar MR scan were found to be related to vBMD. There was a correlation between the degree of paraspinal muscle PDFF and decreasing vBMD, as well as a decrease paraspinal muscle CSA with decreasing vBMD. These findings suggest that clinical management should consider offering tailored treatment options for patients with LDH based on these associations.
越来越多的研究表明，脊柱旁肌脂肪浸润可能是骨质疏松评估的潜在生物学标志物。我们的目的是研究 MRI 上腰椎旁肌特性与基于 QCT 的容积骨密度（vBMD）之间的关系，以评估腰椎间盘突出症（LDH）患者的脊柱旁肌特性。
本回顾性研究共纳入 383 例（年龄 24-76 岁，女性 193 例）临床和影像学诊断为 LDH 的患者。在 MRI 上对 L3/4、L4/5 和 L5/S1 水平的多裂肌（MF）、竖脊肌（ES）和腰大肌（PS）测量肌肉横截面积（CSA）和质子密度脂肪分数（PDFF）。使用 QCT 测量 L1 和 L2 水平的两个椎体的 vBMD。根据 vBMD 值将患者分为三组：正常骨密度组（>120mg/cm）、骨量减少组（80-120mg/cm）和骨质疏松组（<80mg/cm）。使用单因素方差分析和事后分析比较三组间脊柱旁肌特性的差异。使用 Pearson 相关系数分析脊柱旁肌特性与 vBMD 的关系。此外，还使用多元线性回归分析进一步评估 vBMD 与脊柱旁肌特性的相关性，同时将年龄和性别也作为预测因子。
在 383 例 LDH 患者中，191 例骨密度正常，129 例骨量减少，63 例骨质疏松。与正常骨密度组和骨量减少组相比，骨质疏松组的脊柱旁肌 PDFF 明显更高，而 CSA 更低（p<0.001）。调整年龄和性别后，发现 MF PDFF 和 PS CSA 是影响 vBMD 的独立因素（p<0.05）。
在 LDH 患者中，IDEAL-IQ 序列和腰椎 MRI 扫描测量的脊柱旁肌特性与 vBMD 相关。脊柱旁肌 PDFF 程度与 vBMD 降低呈正相关，脊柱旁肌 CSA 与 vBMD 降低呈负相关。这些发现表明，在临床管理中，应根据这些关联为 LDH 患者提供量身定制的治疗方案。
