61. Association between sarcopenia of paraspinal muscle and progression of vertebral collapse in osteoporotic vertebral compression fracture

• Published in: North American Spine Society journal (NASSJ) Vol. 18; p. 100399
• Main Author: Cho, Kyu-Jung
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.07.2024
• Subjects: Orthopedics
• ISSN: 2666-5484; 2666-5484
• DOI: 10.1016/j.xnsj.2024.100399

Osteoporotic vertebral compression fracture (OVCF) causes vertebral collapse and kyphotic deformity, resulting in persistent back pain and a neurologic deficit. Progression of vertebral collapse and kyphotic deformity may be associated with osteoporosis, comminution of fracture, and high BMI. The aim of this study was to analyze the association between sarcopenia of paravertebral muscle and the progression of vertebral collapse and kyphotic deformity in OVCF. A retrospective comparative study. We evaluated 51 patients with thoracolumbar OVCF (age range 65–85 years) from January 2016 to December 2021. Clinical and radiological data were compared between the groups. Vertebral collapse (VC) and kyphotic angle (KA) were measured in a series of x-rays. Relative cross-sectional area (RCSA) and fat infiltration (FI) of paraspinal muscle were measured in an MRI. The multifidus (MF), erector spinae (ES), and psoas major (PS) were quantitatively measured at the level of the L4-5 intervertebral disc. The subjects were divided into two groups according to the progression of VC: Group I: progression of VC was less than 2-fold at 12 months compared to the initial radiograph. Group II: progression of VC was 2-fold or more at 12 months compared to the initial radiograph. Group I showed a higher RCSA of ES and a lower FI than group II (p = 0.034 and p = 0.003, respectively). The progression of VC was correlated with RCSA of ES (r = -0.238, p = 0.044) and FI of paraspinal muscle (r = 0.545, p = 0.001). The progression of KA was correlated with a higher FI of paraspinal muscle (r = 0.222, p = 0.049). By logistic regression analysis, the lower RCSA of ES (odds ratio [OR], 0.025; 95% confidence interval [CI], 0.001−0.445; p=0.025) and higher FI (OR, 8.372; 95% CI, 1.462-47.931; p=0.017) were risk factors for the progression of VC. Sarcopenia of the erector spinae and higher fat infiltration of paraspinal muscle were found to be significant risk factors for the progression of vertebral collapse in thoracolumbar OVCF. This abstract does not discuss or include any applicable devices or drugs.