Sarcopenia Is an Independent Risk Factor for Subsequent Osteoporotic Vertebral Fractures Following Percutaneous Cement Augmentation in Elderly Patients

Abstract

Introduction: Subsequent osteoporotic vertebral fractures (SOVF) are a serious complication of osteoporosis that can lead to spinal deformity, chronic pain and disability. Several risk factors have been previously identified for developing SOVF. However, there are conflicting reports regarding the association between sarcopenia and multiple vertebral compression fractures. As such, the goal of this study was to investigate whether sarcopenia is an independent risk factor of SOVF. Methods:This was a retrospective case–control study of elderly patients who underwent percutaneous vertebral augmentation (PVA) due to a new osteoporotic vertebral compression fracture (OVCF). Collected data included: age, sex, BMI, steroid treatment, fracture level and type, presence of kyphosis at the level of the fracture and bone mineral density (BMD). Identification of SVOFs was based on clinical notes and imaging corroborating the presence of a new fracture. Sarcopenia was measured using the normalized psoas muscle total cross-sectional area (nCSA) at the L4 level. Results: Eighty-nine patients that underwent PVA were followed for a minimum of 24 months. Average age was 80.2 ± 7.1 years; 58 were female (65.2%) and 31 male (34.8%). Psoas muscle nCSA was significantly associated with age (p = 0.031) but not with gender (p = 0.129), corticosteroid treatment (p = 0.349), local kyphosis (p = 0.715), or BMD (p = 0.724). Sarcopenia was significantly associated with SOVF (p = 0.039) after controlling for age and gender. Conclusions: Psoas muscle nCSA can be used as a standalone diagnostic tool of sarcopenia in patients undergoing PVA. In patients undergoing PVA for OVCF, sarcopenia is an independent risk factor for SOVF.

Prediction of Subsequent Vertebral Fracture After Acute Osteoporotic Fractures from Clinical and Paraspinal Muscle Features

“…Sarcopenia is associated with higher risk of falls and fractures [ 43 ], and is a major risk factor for loss of independence in older adults [ 44 ]. In addition, many studies reported that sarcopenia was associated with vertebral fracture [ 20 , 32 , 45 – 47 ]. The above results are consistent with those of this study.…”

Lower psoas mass indicates worse prognosis in percutaneous vertebroplasty-treated osteoporotic vertebral compression fracture

“…Contemporary research indicates a substantial interrelationship between sarcopenia and osteoporosis, which reciprocally exacerbate one another, culminating in detrimental consequences such as falls and fractures 21 . Sarcopenia is widely acknowledged as an independent risk factor for OVCF, impacting the prognosis distinct from osteoporosis 22 . Contrarily, some academics contend that sarcopenia, through its intimate association with osteoporosis, enhances the likelihood of OVCF, though it is not an independent risk factor 23 .…”

Comparison Between the Clinical Effect of Percutaneous Kyphoplasty for Osteoporosis Vertebral Compression Fracture Patient with or Without Sarcopenia: A Retrospective Cohort Study

“… 24 Lidar et al analyzed the data of 237 patients with OVCFs who underwent PKP and found that sarcopenia was an independent risk predictor of refracture in OVCF patients after PKP (OR 2.271; 95% CI 1.069–4.824; P = 0.033). 25 Overall, clarifying the effect of sarcopenia on the clinical outcomes of patients with OVCF after PKP is of great clinical significance. In this study, we compared clinical and radiological outcomes between the SPKP and NPKP groups.…”