腰肌参与骨质疏松性脊椎骨折的发生

Constance Lambeaux , Franck Lapègue , Hélio Fayolle , Yannick Degboe , Hélène Chiavassa-Gandois , Hubert Basselerie , Céline Goumarre , Romain Bilger , Nicolas Sans , Marie Faruch-Bilfeld
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引用次数: 0

摘要

目的 确定腰部肌肉组织(椎旁肌-PVM 和腰大肌-PM)缺陷是否与骨质疏松症患者椎体骨折发生率较高有关。方法 对近期在 T10 至 L5 之间发生过一次或多次骨质疏松症性椎体骨折的患者进行回顾性数据收集,如非注射式计算机断层扫描(CT)、双能量 X 射线吸收测量(DXA),以构成骨折组。根据患者的年龄、DXA 测量的骨矿密度和性别进行配对,形成对照组。我们根据与身体面积相适应的横截面积(CSA)分析了 PM 和 PVM 的萎缩情况,还根据三级脂肪浸润和以 Hounsfield 单位(HU)为单位的平均肌肉密度进行了分析。骨折组的 PVM CSA 低于对照组(分别为 2197.92 ± 460.19 对 2335.20 ± 394.42 mm2.m-2,p = 0.015),但 PM 没有显著差异(分别为 746.92 ± 197.89 对 731.74 ± 215.53 mm2.m-2,p = 0.575)。骨折组的脂肪浸润等级高于对照组(PM:1.3 ± 0.46 对 1.07 ± 0.25,p < 0.001;PVM:1.93 ± 0.5 对 1.74 ± 0.5,p = 0.003),平均肌肉密度较低(PM:26.99 ± 12.83 对 33.91 ± 8.12 HU,p < 0.001; PVM: 3.42 ± 21.06 versus 12.94 ± 18.88 HU, p < 0.001)。建议骨质疏松症患者进行预防性强化训练。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lumbar muscle involvement in the occurrence of osteoporotic vertebral fracture

Objective

To determine if a lumbar musculature deficiency (paravertebral – PVM – and psoas – PM – muscles) is associated with a higher prevalence of vertebral fractures in osteoporotic patients.

Methods

To constitute the fracture group, data were collected retrospectively from patients with one or more recent osteoporotic vertebral fractures between T10 and L5 such as non-injected computerized tomography (CT), dual-energy X-ray absorptiometry (DXA). A control group was made by matching the patients on age, bone mineral density measured by DXA and gender. We analyzed PM and PVM atrophy based on cross-sectional area (CSA) adjusted to the body area as well as fatty infiltration on a 3-level scale and the average muscle density in Hounsfield units (HU).

Results

One hundred seventeen patients were included in each group. The fracture group had a lower PVM CSA than the control group (2197.92 ± 460.19 versus 2335.20 ± 394.42 mm2.m−2, respectively p = 0.015), but there was no significant difference in the PM (746.92 ± 197.89 versus 731.74 ± 215.53 mm2.m−2, respectively p = 0.575). The fracture group had a higher grade of fatty infiltration than the control group (PM: 1.3 ± 0.46 versus 1.07 ± 0.25, p < 0.001; PVM: 1.93 ± 0.5 versus 1.74 ± 0.5, p = 0.003) and a lower average muscle density (PM: 26.99 ± 12.83 versus 33.91 ± 8.12 HU, p < 0.001; PVM: 3.42 ± 21.06 versus 12.94 ± 18.88 HU, p < 0.001).

Conclusion

This study shows an association between a lack of axial musculature and the occurrence of osteoporotic vertebral fractures. Preventive strengthening exercises could be proposed to osteoporotic patients.

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