Sönmez Evren, Tekin Abdurrahim, Oğuzhanasiltürk Dilek Ün, Anlı Ergin, Ayhan Lokman, Dilbaz Suna, Öztürk Akın, Baş Nuri Serdar, Işık Semra, Çevik Serdar
Department of Neurosurgery, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye.
Department of Physical Therapy and Rehabilitation, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye.
J Back Musculoskelet Rehabil. 2025 May 16:10538127251340350. doi: 10.1177/10538127251340350.
BackgroundVertebral compression fractures associated with osteoporosis reduce daily living activities. The primary risk factor for osteoporotic vertebral fractures (OVCFs) is the severity of osteoporosis, defined as low bone mineral density (BMD) in both peripheral and central regions. In addition to BMD, sarcopenia is also thought to affect OVCFs by reducing paraspinal muscle mass and strength.ObjectiveWe aimed to evaluate the association between vertebral compression fractures and paraspinal/psoas muscle characteristics, including muscle mass and fatty degeneration, using quantitative MRI measurements.MethodsWe retrospectively enrolled 77 patients aged ≥60 years who were diagnosed with acute OVCF between January 2019 and August 2023. The control group consisted of age- and sex-matched patients with osteoporosis (BMD > -2.5) who were followed up without fractures for at least six months. Demographic characteristics, relative total cross-sectional area (rTCSA) and relative functional CSA (rFCSA) of the multifidus (MF), erector spinae (ES), and psoas major (PS) were measured at the L4-5 and L5-S levels on MRI.ResultsThe TCSA and rTCSA of the multifidus (MF) and erector spinae (ES) muscles at both the L4-5 and L5-S1 levels did not show significant differences between the control and OVCF groups. (all p value > 0.05) The mean FCSAL4-5 of the MF 8.97 ± 2.81, ES 16.73 ± 6.49, the mean FCSAL5-1 of the MF 9.43 ± 3.27, ES 10.76 ± 5.79 in the fracture group, while the mean FCSAL4-5 of the MF 11.39 ± 2.6, ES 19.35 ± 4.04, the mean FCSAL5-1 of the MF 13.42 ± 2.56, ES 14.11 ± 4.6 in the non-fracture group. (PMFL4-5 < 0.001, PMFL5-1 < 0.001, PESL4-5 = 0.003, PESL5-1 < 0.001) The mean TCSA of the psoas muscle was significantly higher in the fracture group (17.65 ± 6.21) than in the control group (15.9 ± 4.14) (p = 0.042). Despite the significantly larger total psoas muscle mass in the fracture group, the rFCSA of the psoas muscle was lower in the fracture group (0.81 ± 0.27) compared to the control group (0.89 ± 0.25) (p = 0.046).ConclusionsThe study shows that the functional muscle mass of the paraspinal muscles is significantly lower in patients with osteoporotic vertebral compression fractures (OVCF) as compared to those without fractures. Quantitative measurement of the functional capacity of the paraspinal muscles using MRI can effectively predict the risk of OVCF and enable early intervention and adopt preventive measures to reduce the incidence of these fractures.
背景
与骨质疏松症相关的椎体压缩骨折会降低日常生活活动能力。骨质疏松性椎体骨折（OVCF）的主要危险因素是骨质疏松症的严重程度，其定义为外周和中央区域的低骨矿物质密度（BMD）。除BMD外，肌肉减少症也被认为会通过减少椎旁肌肉质量和力量来影响OVCF。
目的
我们旨在使用定量MRI测量来评估椎体压缩骨折与椎旁/腰大肌特征（包括肌肉质量和脂肪变性）之间的关联。
方法
我们回顾性纳入了2019年1月至2023年8月期间诊断为急性OVCF的77例≥60岁的患者。对照组由年龄和性别匹配的骨质疏松症患者（BMD > -2.5）组成，这些患者至少随访6个月且无骨折。在MRI上于L4-5和L5-S1水平测量多裂肌（MF）、竖脊肌（ES）和腰大肌（PS）的人口统计学特征、相对总横截面积（rTCSA）和相对功能横截面积（rFCSA）。
结果
在L4-5和L5-S1水平，MF和ES肌肉的TCSA和rTCSA在对照组和OVCF组之间均未显示出显著差异。（所有p值>0.05）骨折组中MF在L4-5的平均FCSA为8.97±2.81，ES为16.73±6.49，MF在L5-S1的平均FCSA为9.43±3.27，ES为10.76±5.79，而非骨折组中MF在L4-5的平均FCSA为11.39±2.6，ES为19.35±4.04，MF在L5-S1的平均FCSA为13.42±2.56，ES为14.11±4.6。（PMFL4-5<0.001，PMFL5-1<0.001，PESL4-5 = 0.003，PESL5-1<0.001）骨折组腰大肌的平均TCSA（17.65±6.21）显著高于对照组（15.9±4.14）（p = 0.042）。尽管骨折组腰大肌的总质量显著更大，但骨折组腰大肌的rFCSA（0.81±0.27）低于对照组（0.8
