Lumbar posterior group muscle degeneration: Influencing factors of adjacent vertebral body re-fracture after percutaneous vertebroplasty

Ming Chen; Cekai Yang; Zhuoyan Cai; Youtao Liu; Hao Liu; Jianchao Cui; Zhensong Yao; Yuan Chen

doi:10.3389/fmed.2022.1078403

Lumbar posterior group muscle degeneration: Influencing factors of adjacent vertebral body re-fracture after percutaneous vertebroplasty

Front Med (Lausanne). 2023 Apr 17:9:1078403. doi: 10.3389/fmed.2022.1078403. eCollection 2022.

Authors

Ming Chen¹, Cekai Yang¹, Zhuoyan Cai², Youtao Liu², Hao Liu², Jianchao Cui², Zhensong Yao^{2

3}, Yuan Chen⁴

Affiliations

¹ The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
² Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ Department of Orthopaedics, Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁴ College of Medicine and Recreation, Jiangyang City Construction College, Luzhou, China.

Abstract

Objective: The purpose of the study was to explore the influencing factors of adjacent vertebral re-fracture after percutaneous vertebroplasty (PVP) for osteoporosis vertebral compression fractures (OVCFs).

Methods: We retrospectively analyzed the clinical data of 55 patients with adjacent vertebral re-fracture after PVP operation for OVCFs in our hospital from January 2016 to June 2019, they were followed up for 1 year and included in the fracture group. According to the same inclusion and exclusion criteria, we collected the clinical data of 55 patients with OVCFs without adjacent vertebral re-fracture after PVP in the same period and included them in the non-fracture group. We performed univariate and multivariate logistic regression analysis on the influencing factors of adjacent vertebral re-fracture in patients with OVCFs after PVP.

Results: There were significant differences in body mass index (BMI), bone mineral density (BMD) T-value, amount of bone cement injected, bone cement leakage, history of glucocorticoid use, cross-sectional area (CSA), cross-sectional area asymmetry (CSAA), fat infiltration rate (FIR), and fat infiltration rate asymmetry (FIRA) of lumbar posterior group muscles [multifidus (MF) and erector spinae (ES)] between the two groups (p < 0.05). There was no significant difference in sex, age, or time from the first fracture to operation, the CAS, CSAA, FIR, and FIRA of psoas major (PS) between the two groups (p > 0.05). Multivariate logistic regression showed that a higher dose of bone cement, greater CSAA and FIR of multifidus, and higher CSAA of erector spinae were independent risk factors for recurrent fractures of adjacent vertebrae after PVP.

Conclusion: There are many risk factors for recurrent vertebral fracture after PVP in patients with OVCFs, and degeneration of paraspinal muscles (especially posterior lumbar muscles) may be one of the risks.

Keywords: chronic diseases in the elderly; muscular degeneration of posterior group of lumbar spine; osteoporotic vertebral compression fracture; percutaneous vertebroplasty (PVP); vertebral body re-fracture.

Publication types

Review