绝经后女性骨质疏松性椎体压缩骨折腰椎椎旁肌肉的质与量:基于MRI的病例对照研究  

Lumbar paraspinal muscle quantity and quality in postmenopausal women with osteoporotic vertebral compression fractures:a case⁃control study based on MRI

作　　者：张威 秦万元 朱勇[1] 罗伟[1] 欧云生[1] ZHANG Wei;QIN Wan-yuan;ZHU Yong;LUO Wei;OU Yun-sheng(Department of Orthopaedics,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院骨科,重庆400016

出　　处：《骨科》2021年第1期8-13,共6页ORTHOPAEDICS

摘　　要：目的基于MRI探讨绝经后女性腰椎椎旁肌肉的质量与骨质疏松性椎体压缩骨折(osteo⁃porotic vertebral compression fractures,OVCF)的关系。方法收集我院2014年8月至2018年10月收治的绝经后女性单节段OVCF病例,按1∶1年龄配对选择同时期收治的腰椎退变病例,分别纳入观察组和对照组。最终两组各纳入48例。基于两组病人的腰椎MRI,测量L3/4、L4/5椎间盘水平横断面的椎间盘面积和椎旁肌(竖脊肌、多裂肌、腰大肌)面积,计算腰肌性和脂肪退变比率,并比较两组间上述指标的差异。结果观察组病人L3/4、L4/5椎间盘水平的腰肌性分别为241.6%±85.4%、269.8%±78.3%,明显低于对照组的275.6%±92.7%、314.8%±85.3%;脂肪退变比率分别为13.6%±5.4%、15.9%±6.5%,明显高于对照组的9.7%±2.5%、9.4%±2.6%;组间比较,差异均有统计学意义(P均<0.05)。结论绝经后女性OVCF病人的肌肉净含量减少,肌肉的脂肪浸润程度增加,需要进一步研究证实椎旁肌质量与OVCF的关系以及改善肌肉质量对OVCF发生率的影响。Objective To investigate the relationship between paraspinal muscle quantity/quality and acute osteoporotic vertebral compression fractures(OVCF)of the lumbar spine in postmenopausal women.Methods Cases of postmenopausal women with single acute OVCF in our hospital from August 2014 to October 2018 were collected,patients with lumbar degeneration during the same period were selected according to 1∶1 age matching,and they were included in the observation group and the control group respectively,48 cases in each group.Based on lumbar MRI,the muscle area and intramuscular fat area of the erector spinae,multifidus,and psoas muscle at the levels of L3/4 and L4/5 were measured,and the area of cross⁃sectional MRIs was adjusted by corresponding intervertebral disc area.The lumbar muscularity and fatty degeneration rate between two groups were calculated and compared.Results The lumbar muscularity in observation group at L3/4 and L4/5 was 241.6%±85.4%and 269.8%±78.3%respectively,significantly lower than that in the control group(275.6%±92.7%and 314.8%±85.3%);the fatty degeneration rate was 13.6%±5.4%and 15.9%±6.5%,which was significantly higher than that in the control group(9.7%±2.5%and 9.4%±2.6%).There were significant differences between the two groups(all P<0.05).Conclusion OVCF in postmenopausal women are associated with smaller paraspinal muscle area and larger intramuscular fat area.A further study with more focus on the relationship between paraspinal muscle quantity/quality and OVCF as well as the effect of improving muscle quality on the incidence of OVCF is therefore suggested.

关 键 词：骨质疏松 脊柱骨折 绝经后 椎旁肌肉 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]