[1]孙海波,李想,左维阳,等.多裂肌萎缩和脂肪浸润是导致严重形变骨质疏松性椎体压缩骨折的危险因素[J].中华老年骨科与康复电子杂志,2024,(03):146-152.[doi:DOI：10.3877/cma.j.issn.2096-0263.2024.03.004]
　Sun Haibo,Li Xiang,Zuo Weiyang,et al.Multifidus atrophy and fat infiltration are risk factors for severe deformation of osteoporotic vertebral compression fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2024,(03):146-152.[doi:DOI：10.3877/cma.j.issn.2096-0263.2024.03.004]
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多裂肌萎缩和脂肪浸润是导致严重形变骨质疏松性椎体压缩骨折的危险因素()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2024年03期
页码:
146-152
栏目:
骨质疏松
出版日期:
2024-06-05

文章信息/Info

Title:
Multifidus atrophy and fat infiltration are risk factors for severe deformation of osteoporotic vertebral compression fracture
作者:
孙海波; 李想; 左维阳; 张双江; 陈萌萌; 杨雍
100050 首都医科大学附属北京友谊医院，骨科中心
Author(s):
Sun Haibo;  Li Xiang;  Zuo Weiyang;  Zhang Shuangjiang;  Chen Mengmeng;  Yang Yong.
Department of Orthopedics, Beijing Friendship Hospital Capital Medical University, Beijing 100050, China
关键词:
骨质疏松性椎体压缩骨折;  骨折形变;  多裂肌退变;  脂肪浸润
Keywords:
Osteoporotic vertebral compression fracture;  Fracture deformation;  Degeneration of multifidus muscle;  Fat infiltration
DOI:
DOI：10.3877/cma.j.issn.2096-0263.2024.03.004
文献标志码:
A
摘要:
目的 通过MRI影像学参数，探讨多裂肌的退变与骨质疏松性椎体压缩骨折（OVCF）的骨折形变严重程度的相关性。方法 2021年1月至2022年12月期间，共有156例OVCF患者纳入本研究，收集并分析临床和MRI影像学资料。根据德国骨创伤协会提出新的OF分型标准，我们将OF1型和OF2型定义为骨折轻微压缩组，将OF3-OF5型定义为骨折严重压缩组。采用单因素和多因素Logistic回归分析，探讨OVCF骨折形变严重程度的危险因素。结果 骨折轻微压缩组共纳入65例患者，骨折严重压缩组共纳入91例患者，两组患者的基线资料无统计学差异。单因素分析有统计学差异的指标为：两组多裂肌的相对横截面积（rCSA%）分别为70.12±7.99和67.45±7.74（t=2.093，P＜0.05）；两组多裂肌的相对有效功能面积（relative Effective Functional Area，rEFA%）分别为42.03±7.64和35.31±8.16（t=5.202，P＜0.05）；两组多裂肌的脂肪浸润程度（Degree of Fatty Infiltration，DFI%）分别为52.26±7.45和55.51±7.28，（t=2.724，P＜0.05）。多因素Logistic回归分析结果提示，多裂肌的rEFA%[P=0.000＜0.05，OR=0.906, 95% CI为（0.863，0.950）]和多裂肌的DFI%[P＜0.05，OR=1.055，95% CI（1.006，1.107）]是导致严重形变的OVCF的独立影响因素。结论 多裂肌的肌纤维的萎缩和脂肪浸润，是肌肉退变和功能障碍的重要特征，也是导致严重形变的OVCF独立影响因素。规律的多裂肌运动方案，可以有效地减缓多裂肌的退变，从而降低发生严重形变的OVCF的可能性。
Abstract:
Objective To investigate the association between the degeneration of the multifidus muscle and the severe deformationof osteoporotic vertebral compression fracture (OVCF) utilizing magnetic resonance imaging (MRI) parameters. Methods From January 2021 to December 2022, a total of 156 OVCF patients were selected and included in this study. Clinical and MRI imaging data were collected and analyzed. The German Orthopedic Trauma Association had proposed a new classification standard for OVCF, and we defined OF1 and OF2 as the slightly compressed group, and OF3-OF5 as the severely compressed group. Univariate and multivariate logistic regression analysis were employed to identify risk factors predictive of OVCF severity. Results The study divided participants into slightly compressed (65 patients) and severely compressed groups (91 patients), finding no significant differences in baseline characteristics between them. Statistically significant differences identified through univariate analysis included relative Cross-Sectional Area (rCSA%) of the multifidus muscle (70.12±7.99 vs. 67.45±7.74, t=2.093, P=0.038); relative Effective Functional Area (rEFA%) of the multifidus muscles (42.03 ± 7.64 vs. 35.31±8.16, t=5.202, P<0.001); and Degree of Fatty Infiltration (DFI%) of the multifidus muscle(52.26±7.45 vs. 55.51±7.28, t=2.724, P=0.007). Multivariate logistic regression analysis revealed that rEFA% (P<0.001, OR=0.906, 95% CI [0.863, 0.950]) and DFI% (P=0.029, OR=1.055, 95% CI [1.006, 1.107]) of the multifidus muscle served as independent predictors for the severe deformation of OVCF. Conclusions Atrophy and fat infiltration of the multifidus muscle were important feature for degeneration and dysfunction, serving as independent influencing factors for the severity of OVCF. A regular multifidus muscle exercise regimen can effectively slow down the degeneration of multifidus muscles, thereby reducing the likelihood of severe OVCF.

备注/Memo

备注/Memo:
基金项目：北京自然科学基金（批号：L202031）
更新日期/Last Update: 2024-09-03