Comparative analysis of the correlation between paraspinal muscles fat infiltration and vertebral bone quality in patients with lumbar degenerative diseases.

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Siyi Wang, Yongdi Wang, Zhe Wang, Youwei Ai, Qian Chen, Yize Zhao, Ruibang Wu, Yong Huang, Ce Zhu, Limin Liu, Ganjun Feng
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引用次数: 0

Abstract

Purpose: This study aimed to comprehensively evaluate the association between paraspinal muscle fat infiltration (FI) and three MRI-based vertebral bone quality indicators-Vertebral Bone Quality (VBQ), Modified VBQ (MVBQ), and Endplate Bone Quality (EBQ)-in patients with lumbar degenerative diseases (LDD), and to compare their diagnostic and prognostic implications.

Methods: A retrospective analysis included 261 patients undergoing transforaminal lumbar interbody fusion (TLIF) for LDD. Paraspinal muscle parameters-total cross-sectional area (TCSA), functional CSA (FCSA), relative FCSA (rFCSA), and fat infiltration rate (FIR)-were obtained from preoperative MRI. VBQ, MVBQ, and EBQ scores were also calculated. Patients were stratified into high and low FI groups based on FIR quartiles. Correlation and multivariable regression analyses were performed, and diagnostic performance was assessed using Receiver Operating Characteristic (ROC) curves, Clinical outcomes (Oswestry Disability Index (ODI), Visual Analogue Scale (VAS)) were followed up for 2 years.

Results: Patients with high FI exhibited significantly elevated VBQ (3.41 vs. 3.01, p < 0.001), MVBQ (3.47 vs. 2.91, p < 0.001), and EBQ (3.31 vs. 2.97, p = 0.001) scores compared to the normal FI group. FIR correlated positively with all bone quality indices, with the strongest association for MVBQ (r = 0.432, p < 0.001). MVBQ demonstrated superior diagnostic performance (AUC = 0.70) compared to VBQ (AUC = 0.64) and EBQ (AUC = 0.53). At 2-year follow-up, high FI patients had worse ODI scores (11.61 vs. 10.57, p = 0.031), though no differences in VAS were observed.

Conclusion: Our study established a significant association between paraspinal muscles FI and the bone quality of various regions of the vertebrae, as well as prognosis undergoing surgery for LDD patients. MVBQ may serve as a reliable and practical preoperative marker for musculoskeletal degeneration in patients with LDD, guiding individualized risk stratification and rehabilitation planning.

腰椎退行性疾病患者棘旁肌脂肪浸润与椎体骨质量相关性的比较分析。
目的:本研究旨在全面评估腰椎退行性疾病(LDD)患者椎旁肌脂肪浸润(FI)与三个基于mri的椎体骨质量指标(椎体骨质量(VBQ)、改良VBQ (MVBQ)和终板骨质量(EBQ)之间的关系,并比较它们的诊断和预后意义。方法:回顾性分析261例经椎间孔腰椎椎体间融合术治疗LDD的患者。术前MRI获取椎旁肌参数-总横截面积(TCSA)、功能CSA (FCSA)、相对FCSA (rFCSA)和脂肪浸润率(FIR)。同时计算VBQ、MVBQ和EBQ得分。根据FIR四分位数将患者分为高FI组和低FI组。进行相关分析和多变量回归分析,采用受试者工作特征(ROC)曲线评估诊断表现,临床结果(Oswestry残疾指数(ODI)、视觉模拟量表(VAS))随访2年。结果:高FI患者表现出显著的VBQ升高(3.41 vs. 3.01, p)。结论:我们的研究建立了椎骨旁肌肉FI与椎骨各区域的骨质量以及LDD患者手术预后之间的显著关联。MVBQ可作为LDD患者肌肉骨骼退行性变的可靠实用的术前指标,指导个体化风险分层和康复规划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Spine Journal
European Spine Journal 医学-临床神经学
CiteScore
4.80
自引率
10.70%
发文量
373
审稿时长
2-4 weeks
期刊介绍: "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe
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