| Objective: To investigate the structural changes of paralumbar muscles in patients with osteoporotic vertebral compression fracture(OVCF),and analyze the relationship between the imaging structural parameters of paralumbar muscles and the severity of OVCF,commonly used clinical scores,in order to provide new ideas for clinical prevention and rehabilitation of OVCF.Methods: The patients with clinically confirmed OVCF and non-fracture patients with osteoporosis from January 1,2020 to January 1,2022 were retrospectively collected.Match according to age and gender.According to the inclusion and exclusion criteria,a total of 334 subjects were included,including 167 in OVCF group(44 males and 123 females)and 167 in control group(44 males and 123females).The basic clinical data,bone mineral density(BMD),fracture risk assessment tool(FRAX),fall risk score and activity of daily living(ADL)scale of the two groups of patients were collected.All subjects were scanned with conventional sagittal T2 WI,sagittal T1 WI and axial T2 WI of the lumbar spine to determine the Genant classification of the fractured vertebral body in OVCF group.The cross sectional area(CSA),lumbar cross sectional area(LCSA),standard cross sectional area(s CSA),pure muscle cross sectional area(p CSA),fat cross sectional area(f CSA),fat infiltration rate(FI)of the lumbar paravertebral muscles(erector and multifidus)at the upper endplate of L3 vertebral body were measured by manual segmentation and gray value analysis;Measure the lumbar indentation value(LIV)at the upper edge of L3 intervertebral disc;The vertebral bone quality(VBQ)score was measured on sagittal T1 WI.To statistically analyze the relationship between the parameters of lumbar paravertebral muscles and the severity of fracture and the ability of daily activities in OVCF patients.Results: The fractures of OVCF patients mostly occurred at T11-L2 level,and most of them were at Genant 2 level(58.0%).The f CSA and FI of paralumbar muscles in OVCF patients were higher than those in the control group,and the difference was statistically significant(p<0.05).The f CSA of the left paralumbar muscle of OVCF patients was smaller than that of the control group,and the f CSA of the right paralumbar muscle was larger than that of the control group,and the difference was statistically significant(p<0.05).The score of ADL scale in OVCF group was significantly lower than that in control group(p<0.001).The changes of p CSA and FI between different Genant grades in OVCF patients were statistically significant(p<0.05),that is,the p CSA of paravertebral muscles with Genant grade 3 was significantly lower than that of grade 2,and the FI of paravertebral muscles with Genant grade 3 was significantly higher than that of grade 1 and grade 2.Genant grade was positively correlated with FI(r=0.265,p=0.001).In OVCF patients,the p CSA of male paralumbar muscles is larger than that of female,and the FI of female paralumbar muscles is larger than that of male,and the difference is statistically significant(p=0.007;p=0.004).Correlation analysis showed a low negative correlation between VBQ score and BMD(T value)(r=-0.253,p<0.01),and a low positive correlation between VBQ score and age(r=0.287,p<0.01);LIV was negatively correlated with age(r=-0.228,p<0.01).There was a varying degree of correlation between imaging parameters of the lumbar paravertebral muscles and clinical parameters(p<0.05),with a moderate negative correlation between FI and BMD(T value)(r=-0.433,p<0.01).Conclusions: 1.With the increase of age,the fat infiltration in the paralumbar muscles of OVCF patients is more obvious.The degree of fat infiltration is positively correlated with the severity of fracture,and the paralumbar muscle atrophy and fat infiltration are more obvious in women.2.LIV and VBQ scores have specific correlation with aging,paravertebral muscle atrophy and fat infiltration,which may be used as a simple tool to evaluate paravertebral muscle degeneration and help prevent the occurrence of OVCF in clinical early stage. |
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