Can paraspinal muscle degeneration be a reason for refractures after percutaneous kyphoplasty? A magnetic resonance imaging observation

Journal of Orthopaedic Surgery and Research

Jian Chen¹  Wei Bao²  Yan He³  Ji-Jun Liu⁴  Yuan-Ting Zhao⁴  Qing-Da Li⁴  Peng Liu⁴  Ding-Jun Hao⁴  Jun-Song Yang⁴  Bing Qian⁵  He Zhao⁵ 

[1]Department of Orthopedics, Guolong Hospital, 750004, Yinchuan, Ningxia, People’s Republic of China

[2]Department of Orthopedics, People’s Hospital of Chongqing Banan District, Chongqing, People’s Republic of China

[3]Department of Radiology, Honghui Hospital, Xi’an Jiaotong University, No. 76 Nanguo Road, 710054, Xi’an, Shaanxi, People’s Republic of China

[4]Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, No. 76 Nanguo Road, 710054, Xi’an, Shaanxi, People’s Republic of China

[5]Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, No. 76 Nanguo Road, 710054, Xi’an, Shaanxi, People’s Republic of China

[6]Department of emergency, Honghui Hospital, Xi’an Jiaotong University, No. 76 Nanguo Road, 710054, Xi’an, Shaanxi, People’s Republic of China

关键词: Osteoporosis;    Vertebral compression fracture;    Treatment;    Vertebral fracture;    Paraspinal muscle atrophy;    Imaging modality;   

DOI  :  10.1186/s13018-021-02623-y

来源: Springer

【 摘 要 】

BackgroundVertebral augmentation (VA) techniques are used to treat acute osteoporotic vertebral compression fractures (OVCFs). However, the incidence of recurrent vertebral fractures after VA is controversial. Various factors have been discussed in the literature, but no convincing study on the quality of paraspinal muscles has been reported. The purposes of this study were to evaluate the changes in paraspinal muscles and discuss the relationship between paraspinal muscle degeneration and vertebral refractures after percutaneous kyphoplasty (PKP).MethodsThis retrospective study was conducted in patients who underwent PKP for an initial OVCF between July 2017 and August 2018. Patients were followed up and categorized in the refractured or non-refractured group. A final magnetic resonance imaging (MRI) scan and a preoperative MRI scan were used to determine the measurements. The paraspinal muscles at the mid-height level of the initial fractured vertebral body were measured using regions of interest (ROIs), including the cross-sectional area (CSA) and signal intensity (SI). The changes in the observed data were compared between the groups using rank-sum tests.ResultsOverall, 92 patients were enrolled in the study; 33 of them sustained vertebral refractures during the follow-up and the other 59 patients did not. There were no significant differences in terms of sex, age, preoperative bone mineral density, and body mass index between the groups (all, P > 0.05). The refractured group had a significantly higher decrease in the ROI-CSA and CSA/SI, and a higher increase in ROI-SI, compared with the preoperative data (all, P < 0.05).ConclusionsThe quality of paraspinal muscles significantly decreased in patients with new OVCFs after PKP. This brings a new perspective to the study of postoperative recurrent fractures; patients and physicians need to pay more attention to the efficacy of bed rest and bracing.

【 授权许可】

CC BY