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Review
. 2023 Apr 17:9:1078403.
doi: 10.3389/fmed.2022.1078403. eCollection 2022.

Lumbar posterior group muscle degeneration: Influencing factors of adjacent vertebral body re-fracture after percutaneous vertebroplasty

Ming Chen  1 , Cekai Yang  1 , Zhuoyan Cai  2 , Youtao Liu  2 , Hao Liu  2 , Jianchao Cui  2 , Zhensong Yao  2   3 , Yuan Chen  4
Affiliations
Review

Lumbar posterior group muscle degeneration: Influencing factors of adjacent vertebral body re-fracture after percutaneous vertebroplasty

Ming Chen et al. Front Med (Lausanne). .

Abstract

Objective: The purpose of the study was to explore the influencing factors of adjacent vertebral re-fracture after percutaneous vertebroplasty (PVP) for osteoporosis vertebral compression fractures (OVCFs).

Methods: We retrospectively analyzed the clinical data of 55 patients with adjacent vertebral re-fracture after PVP operation for OVCFs in our hospital from January 2016 to June 2019, they were followed up for 1 year and included in the fracture group. According to the same inclusion and exclusion criteria, we collected the clinical data of 55 patients with OVCFs without adjacent vertebral re-fracture after PVP in the same period and included them in the non-fracture group. We performed univariate and multivariate logistic regression analysis on the influencing factors of adjacent vertebral re-fracture in patients with OVCFs after PVP.

Results: There were significant differences in body mass index (BMI), bone mineral density (BMD) T-value, amount of bone cement injected, bone cement leakage, history of glucocorticoid use, cross-sectional area (CSA), cross-sectional area asymmetry (CSAA), fat infiltration rate (FIR), and fat infiltration rate asymmetry (FIRA) of lumbar posterior group muscles [multifidus (MF) and erector spinae (ES)] between the two groups (p < 0.05). There was no significant difference in sex, age, or time from the first fracture to operation, the CAS, CSAA, FIR, and FIRA of psoas major (PS) between the two groups (p > 0.05). Multivariate logistic regression showed that a higher dose of bone cement, greater CSAA and FIR of multifidus, and higher CSAA of erector spinae were independent risk factors for recurrent fractures of adjacent vertebrae after PVP.

Conclusion: There are many risk factors for recurrent vertebral fracture after PVP in patients with OVCFs, and degeneration of paraspinal muscles (especially posterior lumbar muscles) may be one of the risks.

Keywords: chronic diseases in the elderly; muscular degeneration of posterior group of lumbar spine; osteoporotic vertebral compression fracture; percutaneous vertebroplasty (PVP); vertebral body re-fracture.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Measurement of cross-sectional area and intermuscular fat area of paraspinal muscle (A) (MF, multifidus; ES, erector spinae; PS, psoas major). (B) The automatic threshold setting of ImageJ distinguish fat from muscle. The range of the yellow curve is the left MF, and the red part is the fat area of MF.
FIGURE 2
FIGURE 2
Difference of paraspinal muscles parameters between the two groups (A, non-fracture group; B, fracture group). (A) left multifidus; (B) right multifidus; (C) left erector spinae; (D) right erector spinae; (E) left psoas major; and (F) right psoas major. MF-CSA, cross-sectional area of multifidus; MF-FIR, fat infiltration rate of multifidus; ES-CSA, cross-sectional area of erector spinae; ES-FIR, fat infiltration rate of erector spinae; PS-CSA, cross-sectional area of psoas major; PS-FIR, fat infilt ration rate of psoas major; Left, left paraspinal muscle; Right, right paraspinal muscle. Data are reported as mean ± standard deviation of mean. *p < 0.05, **p < 0.01, and ***p < 0.001.
See this image and copyright information in PMC

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