Impact of Multifidus Muscle Atrophy on the Occurrence of Secondary Symptomatic Adjacent Osteoporotic Vertebral Compression Fractures

Abstract

To assess the potential influence of multifidus atrophy and fatty degeneration on the incidence of adjacent vertebral compression fractures within one year after the index fracture. In a retrospective cohort study, patients who underwent surgery for an OVCF were identified and baseline characteristics, fracture patterns and the occurrence of secondary adjacent fractures within one year were obtained by chart review. Multifidus muscle atrophy and fatty degeneration were determined on preoperative MRI or CT scans. In this analysis of 191 patients (mean age 77 years, SD 8, 116 female), OF type 3 was the most common type of OVCF (49.2%). Symptomatic adjacent OVCFs within one year after index fracture were observed in 23/191 patients (12%) at mean 12, SD 12 weeks (range 1–42 weeks) postoperatively. The mean multifidus muscle area was 264, SD 53 mm2 in patients with an adjacent vertebral fracture and 271, SD 92 mm2 in patients without a secondary fracture (p = 0.755). Mean multifidus fatty infiltration was graded Goutallier 2.2, SD 0.6 in patients with an adjacent fracture and Goutallier 2.2, SD 0.7 in patients without an adjacent fracture (p = 0.694). Pre-existing medication with corticosteroids was associated with the occurrence of an adjacent fracture (p = 0.006). Multifidus area and multifidus fatty infiltration had no significant effect on the occurrence of adjacent vertebral fractures within one year after the index fracture. Patients with a pre-existing medication with corticosteroids were more likely to sustain an adjacent fracture.

The association of vertebral compression fracture progression with paraspinal muscle and psoas muscle degeneration

“…Katsu et al [18] reported that the erect spinal muscle has a marked influence on fracture union of the VCF. However, Osterhoff et al [7] reported that the multifidus area and fatty infiltration had no significant effect on the occurrence of adjacent vertebral fractures within 1 year of the index fracture. In addition, the paraspinal muscle does not affect vertebral collapse but the revised paraspinal muscle does.…”

“…Fatty infiltration of the multifidus, erect spinae, and psoas muscle were determined by measuring the cross-sectional area (CSA) of the mus-cles in T2-weighted MRI using the threshold grayscale in ImageJ (Fig. 2) [7,8]. The paraspinal muscle mass, excluding fat, was calculated by multiplying the ratio of fat by the simple area of the paraspinal muscle.…”

“…Previous studies have focused on VCF progression and have analyzed vertebral body fracture shape, presence of an intravertebral cleft, posterior wall damage, middle column damage, and VCF progression [5,6]. However, few studies have investigated the association between spinal muscle fatty degeneration and VCF progression, which were published only recently [7,8]. Therefore, our study is an additional study on the association between spinal muscles fatty degeneration, functional support of the spinal muscles, and VCF progression.…”

Associations between paraspinal muscles fatty infiltration and lumbar vertebral bone mineral density – An investigation by fast kVp switching dual-energy CT and QCT

“…To our knowledge, several previous studies have found that paraspinal muscles fatty infiltration is related to age, disc level, inter-vertebral disc degeneration, vertebral bone marrow and low-back pain [21] , [29] , [30] , [31] , and many researches have investigated the relationship between the changes of paraspinal muscles(muscle and fat volume, cross sectional area etc.) and osteoporotic spinal compression fractures [32] , [33] , [34] , but relatively few researches have been carried out to directly investigate the interaction between fatty infiltration of paraspinal muscles and BMD so far. Recently Yinxia Zhao et al reported that the technique of six-echo chemical shift encoding-based water-fat MRI was capable of assessing paraspinal muscles fat infiltration using quantifying proton density fat fractions (PDFF) [19] .…”

Three-Dimensional Reconstruction of a CT Image under Deep Learning Algorithm to Evaluate the Application of Percutaneous Kyphoplasty in Osteoporotic Thoracolumbar Compression Fractures

“…The neural network is a mathematical model or computational model that imitates the structure and function of the biological neural network, which consists of the input layer, hidden layer, and output layer. As a technology oriented to 3D data processing, V-Net neural network [ 17 ] belongs to the coding-decoding structure. Moreover, the network on the left continuously helps to reduce the resolution of the image to extract features, and the right one is helpful to decode the image to restore it to the original size.…”