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. 2025 Sep 2:20:1471-1480.
doi: 10.2147/CIA.S532935. eCollection 2025.

The Relation of Osteoporotic Vertebral Fractures and Sarcopenic Characteristics on the Occurrence of Complications: A Systematic Review

Elisabeth Roschke  1 , Dina Wilma Wiersbicki  1 , Philipp Pieroh  1 , Christoph-Eckhard Heyde  1 , Georg Osterhoff  1
Affiliations

The Relation of Osteoporotic Vertebral Fractures and Sarcopenic Characteristics on the Occurrence of Complications: A Systematic Review

Elisabeth Roschke et al. Clin Interv Aging. .

Abstract

Study design: Systematic review.

Purpose: As the number of elderly increases, age-related changes of body composition like osteoporosis and sarcopenic muscle changes contribute to higher morbidity, less quality of life and higher health care costs. Data on the effect of muscle atrophy on osteoporotic vertebral fractures is limited. We systematically reviewed the current literature for the influence of preexisting degenerative muscle changes in patients with OVF on the occurrence of complication during and after treatment.

Methods: A systematic literature review adherent to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was performed using the Web of Science and Medline databases. We considered English and German articles from January 1990 to December 2022. Inclusion criteria covered patients with OVF and muscle degeneration with complications during and after treatment. Included trials were cohort studies and case series.

Results: Eight Studies were included in this systematic review. One studied the role of degenerated paravertebral muscle during conservative treatment. One article analysed the influence of sarcopenia after dorsal instrumentation in patients with OVF, another the effects of muscle degeneration after dorsal instrumentation or kyphoplasty. The other studies evaluated complications after percutaneous vertebroplasty or kyphoplasty. Seven studies described an increased risk for subsequent fracture following OVF treatment in case of muscle degeneration, despite differing methods and cut-offs for muscle degeneration.

Conclusion: Subsequent fractures were the most frequently analysed complication, others were scarcely analysed. Most studies found a correlation of paravertebral muscle degeneration and the occurrence of secondary OVFs. However, very different methods and cut-offs for sarcopenia assessment were used and it remains unclear what defines muscle changes that lead to an increased risk for complications.

Keywords: muscle degeneration; osteoporosis; osteoporotic vertebral fracture; refracture; sarcopenia.

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Conflict of interest statement

Prof. Dr. Christoph-Eckhard Heyde reports personal fees from Medacta Int., outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study selection process according to PRISMA Guidelines 2020. Adapted from Page M J, McKenzie J E, Bossuyt P M, Boutron I, Hoffmann T C, Mulrow C D et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372 :n71. Creative Commons.
See this image and copyright information in PMC

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