Effects of modified vertebral bone quality score and paravertebral muscle mass on multiple osteoporotic vertebral compression fractures: a retrospective multicenter cohort study
Yongyong Fan1,2, Shujun Chen1,3, Jingjing Li1,4
1Department of Orthopaedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, 318000, Zhejiang, People's Republic of China.
Background:
Multiple osteoporotic vertebral compression fractures (OVCF) are common in clinical practice and often have serious consequences. This study aimed to investigate the factors influencing the occurrence of multiple OVCFs.
Methods:
A total of 652 patients with thoracolumbar OVCF from January 2019 to January 2024 were enrolled and divided into single and multiple OVCF groups. The total cross-sectional area (CSA) and functional cross-sectional area (FCSA) of the L4 multifidus (M), erector spinae (ES), paravertebral muscle (PVM), psoas major, and quadratus lumborum muscles were measured using demographic, underlying disease, and laboratory variables. Fat infiltration rate (FIR) and modified vertebral bone quality (MVBQ) scores were calculated, and correlation and multivariate logistic regression analyses were performed.
Results:
The two groups differed significantly in body mass index and bone mineral density (BMD) (L1-L4). The CSA and FCSA of M, ES, and PVM were smaller in the multiple OVCF group, while FIR and MVBQ scores were higher. Lower BMD (L1-L4), lower ES-FCSA, higher ES-FIR, and higher MVBQ scores were independent risk factors for multiple OVCF. The AUC of the MVBQ was 0.754, with a good predictive value. When MVBQ > 3.975, the risk of multiple OVCFs was 3.767 times that of a single OVCF.
Conclusion:
Independent risk factors for multiple OVCFs were identified. The combination of MVBQ with BMD (L1-L4) and PVM quality holds the potential for accurately identifying high-risk patients with multiple OVCF in the early stage.
