腰椎椎旁肌退变与骨质疏松性腰椎体压缩性骨折术后再骨折的关系  

The correlation between lumbar paravertebral muscle degeneration and postoperative re-fractures for osteoporotic lumbar vertebral compression fractures

作　　者：杨严伟 徐畅 张林林[2] 王骏骅[2] 杨惠林[2] 倪莉[2] YANG Yanwei;XU Chang;ZHANG Linlin;WANG Junhua;YANG Huilin;NI Li(Orthopedics Magnetic Resonance Room;Department of Orthopedics,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China)

机构地区：[1]苏州大学附属第一医院骨科磁共振室,江苏苏州215006 [2]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《实用放射学杂志》2024年第8期1325-1328,共4页Journal of Practical Radiology

摘　　要：目的探讨多裂肌(MF)及竖脊肌(ES)的脂肪浸润度(FI)、相对横截面积(rCSA)与骨质疏松性腰椎体压缩性骨折(OLVCF)术后新发症状性椎体压缩性骨折(NSVCF)的相关性。方法收集157例经手术治疗的OLVCF患者的临床及影像学资料,根据随访周期内是否存在NSVCF分为术后再骨折组(24例)和术后无骨折组(133例)。利用Image J软件测量、计算2组患者腰椎椎旁肌(MF及ES)的FI、rCSA,通过单因素差异性分析比较2组之间的性别、年龄、骨密度(BMD)T值、体质量指数(BMI)、FI、rCSA是否存在差异;采用多因素二元logistic回归分析确定OLVCF术后NSVCF的危险因素。结果单因素差异性分析显示2组间年龄(t=-2.596,P=0.010)、BMD T值(t=2.415,P=0.017)、FI(t=-5.006,P<0.001)的差异有统计学意义,性别(χ^(2)=0.528,P=0.468)、BMI(t=1.354,P=0.178)、rCSA(t=-0.057,P=0.955)的差异无统计学意义;多因素二元logistic回归分析显示2组间FI(χ^(2)=15.560,P<0.001)、BMD T值(χ^(2)=4.193,P=0.041)的差异有统计学意义。结论术前较高的腰椎椎旁肌FI及较低的腰椎BMD T值是OLVCF患者术后NSVCF的危险因素,提醒临床医师注意相关患者的腰背肌功能锻炼及抗骨质疏松治疗。Objective To investigate the correlation between fatty infiltration(FI),relative cross-sectional area(rCSA)of the multifidus(MF),erector spinae(ES)and postoperative new symptomatic vertebral compression fractures(NSVCF)for osteoporotic lumbar vertebral compression fractures(OLVCF).Methods The clinical and imaging data of 157 patients with OLVCF treated by surgery were collected.They were divided into postoperative re-fracture group(24 cases)and postoperative non-fracture group(133 cases)according to the presence or absence of NSVCF during the follow-up period.The FI,rCSA of lumbar paravertebral muscles(MF and ES)in the two groups were measured and calculated using Image J software.Univariate difference analysis was performed to compare whether there were differences in gender,age,T value of bone mineral density(BMD),body mass index(BMI),FI and rCSA between the two groups.Multivariate binary logistic regression analysis was used to determine the risk factors for NSVCF after surgery for OLVCF.Results Univariate difference analysis showed there were significant statistical differences in age(t=-2.596,P=0.010),T value of BMD(t=2.415,P=0.017)and FI(t=-5.006,P<0.001)between the two groups.There were no significant statistical differences in gender(χ^(2)=0.528,P=0.468),BMI(t=1.354,P=0.178)and rCSA(t=-0.057,P=0.955).Multivariate binary logistic regression analysis showed there were significant statistical differences in FI(χ^(2)=15.560,P<0.001),T value of BMD(χ^(2)=4.193,P=0.041)between the two groups.Conclusion The higher FI of lumbar paravertebral muscle and the lower T value of BMD of lumbar spine are the risk factors for postoperative NSVCF in patients with OLVCF.It is recommended that clinicians should pay attention to the functional exercise of lumbar dorsal muscles and the anti-osteoporosis therapy in the relevant patients.

关 键 词：多裂肌 竖脊肌 骨密度 脂肪浸润度 骨质疏松性椎体压缩性骨折 

分 类 号：R681[医药卫生—骨科学] R683[医药卫生—外科学]