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Review
. 2024 Jun 1;14(6):4189-4201.
doi: 10.21037/qims-23-1770. Epub 2024 Apr 15.

Exploring the interplay between paraspinal muscular status and bone health in osteoporosis and fracture risk: a comprehensive literature review on computed tomography (CT) and magnetic resonance imaging (MRI) studies

Carlo A Mallio  1   2 , Claudia Volterrani  1 , Caterina Bernetti  1   2 , Massimo Stiffi  1   2 , Federico Greco  3 , Bruno Beomonte Zobel  1   2
Affiliations
Review

Exploring the interplay between paraspinal muscular status and bone health in osteoporosis and fracture risk: a comprehensive literature review on computed tomography (CT) and magnetic resonance imaging (MRI) studies

Carlo A Mallio et al. Quant Imaging Med Surg. .

Abstract

Background and objective: Computed tomography (CT) and magnetic resonance imaging (MRI) of the spine are fundamental non-invasive tools to investigate the status of the bone and soft tissue in vivo. A novel and promising approach is to investigate the quality and quantity of paraspinal muscles even beyond the clinical question. The aim of the present review is to summarize current evidence on CT and MRI about the relationship between paraspinal muscular status and bone health in osteoporosis (OP) and fracture risk.

Methods: Literature research was carried out on September 2023 using PubMed, Scopus, and Cochrane databases.

Key content and findings: Research investigating the intricate interplay between musculature and bone health reveals that degenerating paraspinal muscles, characterized by shrinking and fatty infiltration, are associated with lower bone mineral density (BMD) and the development of OP. Additionally, research indicates that weaker paraspinal muscles are linked to a higher risk of fractures, including those at the spine.

Conclusions: The findings suggest that paraspinal muscle health may be a significant factor in identifying individuals at risk for OP and fractures. Further investigation is needed to explore the potential of paraspinal muscles in preventing these conditions.

Keywords: Osteoporosis (OP); computed tomography (CT); magnetic resonance imaging (MRI); paravertebral muscles; spine; vertebral fractures.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1770/coif). C.A.M. serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart diagram showing the articles selection process.
Figure 2
Figure 2
Association between osteoporosis and muscle atrophy. Dual-energy X-ray absorptiometry (A) and sagittal T2-weighed MRI (B) of a 79-year-old woman. The images show the association of osteoporosis (A) with fatty degeneration of paraspinal muscles [arrow in (B)]. BMD, bone mineral density; BMC, bone mineral content; AM, age-related; CV, coefficient of variation; ACF, autocorrelation function; BCF, bias correction factor; TH, total hip; CHI, classification.
Figure 3
Figure 3
Association between osteoporosis and vertebral fracture. Sagittal T1-weighted (A), sagittal T2-weighted (B) with fat suppression, and axial T2-weighted MRI (C) of a 75-year-old woman. Non-recent vertebral osteoporotic fracture at L3 [star in (A) and (B)] is detected together with fatty degeneration of paraspinal muscles [arrows in (A), (B) and (C)].
See this image and copyright information in PMC

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