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骨质疏松性椎体压缩骨折经皮椎体后凸成形术后肌肉减少症与残留背痛之间的关联。

Association between sarcopenia on residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fractures.

作者信息

Li Chengming, Ji Hangyu, Cui Daping, Zhuang Suyang, Zhang Cong

机构信息

Department of Spinal Surgery Center, Zhongda Hospital Southeast University, Nanjing, 210009, People's Republic of China.

Department of Orthopedics, Shenzhen Bao'an District Central Hospital, Shenzhen, 518100, People's Republic of China.

出版信息

J Orthop Surg Res. 2025 May 30;20(1):550. doi: 10.1186/s13018-025-05902-0.

Abstract

OBJECTIVE

This study aimed to investigate whether sarcopenia affects residual back pain (RBP) after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).

METHODS

We retrospectively analyzed the clinical data of 231 patients with single-segment OVCF treated with PKP between January 2023 and December 2023. Postoperative RBP was assessed at 1 month using the visual analogue scale (VAS). Patients with a VAS score ≥ 4 were classified as the RBP group, while those with a score < 4 served as controls. Sarcopenia was diagnosed using the skeletal muscle mass index (SMI), calculated by dividing the cross-sectional muscle area at the T12 vertebral level (measured via chest CT) by height squared. Univariate analysis compared clinical and imaging data between groups, and binary logistic regression identified risk factors.

RESULT

No significant differences were observed between groups in gender, BMI, surgical segment, hypertension, diabetes, or coronary heart disease (P > 0.05). However, age, BMD, SMI, bone cement usage, and sarcopenia prevalence differed significantly (P < 0.05). Binary logistic regression identified BMD and sarcopenia as independent risk factors for RBP after PKP.

CONCLUSION

OVCF patients with sarcopenia have a higher likelihood of postoperative RBP, with an incidence approximately twice that of non-sarcopenic patients. Preoperative sarcopenia screening should be prioritized, and postoperative anti-muscular atrophy therapy actively implemented.

摘要

目的

本研究旨在探讨骨质疏松性椎体压缩骨折(OVCF)经皮椎体后凸成形术(PKP)后肌肉减少症是否会影响残留背痛(RBP)。

方法

我们回顾性分析了2023年1月至2023年12月期间接受PKP治疗的231例单节段OVCF患者的临床资料。术后1个月使用视觉模拟量表(VAS)评估残留背痛情况。VAS评分≥4分的患者被归类为RBP组,评分<4分的患者作为对照组。采用骨骼肌质量指数(SMI)诊断肌肉减少症,计算方法为将T12椎体水平的横截面积(通过胸部CT测量)除以身高的平方。单因素分析比较了两组之间的临床和影像学数据,二元逻辑回归确定了危险因素。

结果

两组在性别、BMI、手术节段、高血压、糖尿病或冠心病方面未观察到显著差异(P>0.05)。然而,年龄、骨密度、SMI、骨水泥用量和肌肉减少症患病率存在显著差异(P<0.05)。二元逻辑回归确定骨密度和肌肉减少症是PKP术后RBP的独立危险因素。

结论

患有肌肉减少症的OVCF患者术后发生RBP的可能性更高,发病率约为非肌肉减少症患者的两倍。应优先进行术前肌肉减少症筛查,并积极实施术后抗肌肉萎缩治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/506d/12124072/a785e3e7be3e/13018_2025_5902_Fig1_HTML.jpg

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