Paraspinal muscle parameters' predictive value for new vertebral compression fractures post-vertebral augmentation:...

Area of Science:

• Orthopedics
• Radiology
• Geriatrics

Background:

• Paraspinal muscles are crucial for spinal stability.
• Osteoporotic vertebral compression fractures (OVCF) are common, and subsequent fractures can occur after interventions.
• Predicting new vertebral compression fractures (NVCF) post-treatment is essential for patient management.

Purpose of the Study:

• To evaluate the predictive capability of paraspinal muscle parameters for NVCF occurrence after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) in OVCF patients.
• To develop and validate a predictive model for NVCF.

Main Methods:

• Retrospective analysis of OVCF patients treated with PVP/PKP.
• Data divided into training, validation, and external validation sets.
• Lasso and multivariable logistic regression identified predictors; a Nomogram model was constructed and validated using ROC curves, calibration plots, and decision analysis.

Main Results:

• Surgical approach, spinal CT values, and multifidus skeletal muscle index (SMI) were identified as independent predictors of postoperative NVCF.
• The Nomogram model demonstrated good predictive accuracy with AUC values of 0.801 (training), 0.664 (validation), and 0.832 (external validation).
• The model showed good calibration and clinical utility across various risk thresholds.

Conclusions:

• Multifidus SMI shows significant potential in predicting NVCF, potentially outperforming spinal CT values.
• The developed Nomogram model offers a valuable tool for predicting NVCF in OVCF patients undergoing PVP/PKP.
• The Nomogram model exhibits a strong negative predictive value, aiding in identifying patients at lower risk.