Background: The paraspinal muscle is essential for maintaining normal spine function and structure, which degeneration is closely related to various spinal diseases. The main objective of this study was to identify the potential role of paraspinal muscle degeneration in the occurrence of new vertebral compression fractures (NVCF) and develop a clinically applicable nomogram for prospective NVCF risk prediction.
Methods: A total of 202 patients with single-level osteoporotic vertebral compression fractures (OVCF) who underwent percutaneous kyphoplasty treatment between January 2016 and March 2019 were included in this study. Demographic, clinical, radiological, and treatment data were collected and analyzed. The paraspinal muscle cross-sectional area (CSA) and fat signal fraction (FSF) were measured to quantify the extent of muscle degeneration. Multivariate binary logistic regression analysis was performed to select risk factors to build a nomogram that predicted the occurrence of NVCF. The concordance index (C-index) and calibration curve were used to evaluate the discriminative capacity and predictive accuracy of the nomogram.
Results: NVCF occurred in 54 of 202 patients (26.7%). The erector spinae FSF (OR = 1.064; P = 0.001), psoas major FSF (OR = 1.326; P < 0.001), and the difference index of the muscle CSA between multifidus and psoas major (OR = 1.048; P < 0.001) were independent risk factors for the occurrence of NVCF. The nomogram performance was good after evaluation using the calibration curves and C-index (95% confidence interval, 0.854– 0.943).
Conclusion: Paraspinal muscle degeneration is a potential risk factor for NVCF occurrence. A nomogram was designed to precisely predict the risk of NVCF. This predictive nomogram may help clinicians to make better clinical decisions and provide more accurate functional exercise protocol for OVCF patients.



中文翻译：

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椎旁肌变性：经皮椎体后凸成形术后新椎体压缩性骨折的潜在危险因素

背景：椎旁肌是维持脊柱正常功能和结构所必需的，其退化与各种脊柱疾病密切相关。本研究的主要目的是确定椎旁肌变性在新椎体压缩性骨折 (NVCF) 发生中的潜在作用，并开发用于前瞻性 NVCF 风险预测的临床适用列线图。
方法：本研究共纳入 202 例 2016 年 1 月至 2019 年 3 月期间接受经皮后凸成形术治疗的单节段骨质疏松性椎体压缩性骨折（OVCF）患者。收集和分析人口统计学、临床、放射学和治疗数据。测量椎旁肌肉横截面积 (CSA) 和脂肪信号分数 (FSF) 以量化肌肉退化的程度。进行多变量二元逻辑回归分析以选择风险因素以构建预测 NVCF 发生的列线图。使用一致性指数（C-index）和校准曲线来评估列线图的判别能力和预测准确性。
结果：202 名患者中有 54 名（26.7%）发生 NVCF。竖脊肌 FSF (OR = 1.064; P = 0.001)、腰大肌 FSF (OR = 1.326; P < 0.001) 和多裂肌与腰大肌肌肉 CSA 的差异指数 (OR = 1.048; P < 0.001) NVCF 发生的独立危险因素。使用校准曲线和 C 指数（95% 置信区间，0.854–0.943）评估后，列线图性能良好。
结论：椎旁肌变性是NVCF发生的潜在危险因素。列线图旨在精确预测 NVCF 的风险。这种预测列线图可以帮助临床医生做出更好的临床决策，并为 OVCF 患者提供更准确的功能锻炼方案。