Relationship between oseteoporosis with fatty infiltration of paraspinal muscles based on QCT examination

Li, Xiangwen; Xie, Yuxue; Lü, Rong; Zhang, Yuyang; Tao, Hongyue; Chen, Shuang

doi:10.1007/s00774-022-01311-z

Cited by 8 publications

(3 citation statements)

References 48 publications

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“…The Wiltse approach primarily reduces damage to the paraspinal muscles at the surgical site and contributes to reducing postoperative atrophy and fat infiltration of the multifidus muscles next to the adjacent vertebrae [ 14 , 24 ]. Several studies have shown a strong association between fatty infiltration of the multifidus muscle and lumbar BMD [ 25 , 26 ]. Wang et al [ 13 ] conducted an experimental study in rats and found that bone loss occurred in rats with paraspinal muscular atrophy compared with that in controls.…”

Section: Discussionmentioning

confidence: 99%

Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion

Zhang,

Wang,

Zheng

et al. 2024

Asian Spine J

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Study Design: A retrospective cohort study.Purpose: This study aimed to assess the reliability of quantitative computed tomography (QCT) in measuring bone mineral density (BMD) of instrumented vertebrae and investigate the effect of less paraspinal muscle damage on BMD changes after lumbar interbody fusion.Overview of Literature: Patients always experience a decrease in vertebral BMD after lumbar interbody fusion. However, to the best of our knowledge, no study has analyzed the effect of paraspinal muscles on BMD changes.Methods: This retrospective analysis included a total of 155 patients who underwent single-level lumbar fusion, with 81 patients in the traditional group and 74 patients in the Wiltse group (less paraspinal muscle damage). QCT was used to measure the volumetric BMD (vBMD), Hounsfield unit value, and cross-sectional area of the paraspinal muscles at the upper instrumented vertebrae (UIV), vertebrae one segment above the UIV (UIV+1), and the vertebrae one segment above the UIV+1 (UIV+2). Statistical analyses were performed.Results: No significant differences in general data were observed between the two groups (p>0.05). Strong correlations were noted between the preoperative and 1-week postoperative vBMD of each segment (p<0.01), with no significant difference between the two time points in both groups (p>0.05). Vertebral BMD loss was significantly higher in UIV+1 and UIV+2 in the traditional group than in the Wiltse group (−13.6%±19.1% vs. −4.2%±16.5%, −10.8%±20.3% vs. −0.9%±37.0%; p<0.05). However, no statistically significant difference was observed in the percent vBMD changes in the UIV segment between the two groups (37.7%±70.1% vs. 36.1%±78.7%, p>0.05).Conclusions: QCT can reliably determine BMD in the instrumented spine after lumbar interbody fusion. With QCT, we found that reducing paraspinal muscle destruction through the Wiltse approach during surgery can help preserve the adjacent vertebral BMD; however, it does not help increase the BMD in the instrumented vertebrae.

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Section: Discussionmentioning

confidence: 99%

Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion

Zhang,

Wang,

Zheng

et al. 2024

Asian Spine J

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“…Several studies have investigated the relationship between the properties of paraspinal muscles and vBMD in healthy populations [ 14 , 15 ] or patients with low back pain [ 16 ]. These studies demonstrated that paraspinal muscle fat infiltration was greater in patients with osteoporosis than in patients with normal or osteopenia.…”

Section: Introductionmentioning

confidence: 99%

Relationship between paraspinal muscle properties and bone mineral density based on QCT in patients with lumbar disc herniation

Li,

Chen,

Yang

et al. 2024

BMC Musculoskelet Disord

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Objective Increasing research suggests that paraspinal muscle fat infiltration may be a potential biological marker for the assessment of osteoporosis. Our aim was to investigate the relationship between lumbar paraspinal muscle properties on MRI and volumetric bone mineral density (vBMD) based on QCT in patients with lumbar disc herniation (LDH). Methods A total of 383 patients (aged 24–76 years, 193 females) with clinically and radiologically diagnosed LDH were enrolled in this retrospective study. The muscle cross-sectional area (CSA) and the proton density fat fraction (PDFF) were measured for the multifidus (MF), erector spinae (ES) and psoas major (PS) at the central level of L3/4, L4/5 and L5/S1 on lumbar MRI. QCT was used to measure the vBMD of two vertebral bodies at L1 and L2 levels. Patients were divided into three groups based on their vBMD values: normal bone density group (> 120 mg/cm3), osteopenia group (80 to 120 mg/cm3) and osteoporosis group (< 80 mg/cm3). The differences in paraspinal muscle properties among three vBMD groups were tested by one-way ANOVA with post hoc analysis. The relationships between paraspinal muscle properties and vBMD were analyzed using Pearson correlation coefficients. Furthermore, the association between vBMD and paraspinal muscle properties was further evaluated using multiple linear regression analysis, with age and sex also included as predictors. Results Among the 383 LDH patients, 191 had normal bone density, 129 had osteopenia and 63 had osteoporosis. In LDH patients, compared to normal and osteopenia group, paraspinal muscle PDFF was significantly greater in osteoporosis group, while paraspinal muscle CSA was lower (p < 0.001). After adjusting for age and sex, it was found that MF PDFF and PS CSA were found to be independent factors influencing vBMD (p < 0.05). Conclusion In patients with LDH, paraspinal muscle properties measured by IDEAL-IQ sequence and lumbar MR scan were found to be related to vBMD. There was a correlation between the degree of paraspinal muscle PDFF and decreasing vBMD, as well as a decrease paraspinal muscle CSA with decreasing vBMD. These findings suggest that clinical management should consider offering tailored treatment options for patients with LDH based on these associations.

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“…Some studies ( 4 ) have shown that there is a positive correlation between muscle mass and vertebral bone density, and muscle mass of paravertebral muscles is related to the occurrence of vertebral osteoporosis. With the loss of muscle strength, the stability of vertebral body may decrease, which increase the risk of brittle fractures ( 5 ). The hyperglycemia and insulin resistance in patients with T2DM could both impair muscle tissue, with the decrease of muscle strength and muscle mass and increase of muscle fat infiltration ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

The value of radiomics to predict abnormal bone mass in type 2 diabetes mellitus patients based on CT imaging for paravertebral muscles

Qiu

Yang

et al. 2022

Front. Endocrinol.

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ObjectiveTo investigate the value of CT imaging features of paravertebral muscles in predicting abnormal bone mass in patients with type 2 diabetes mellitus.MethodsThe clinical and QCT data of 149 patients with type 2 diabetes mellitus were collected retrospectively. Patients were randomly divided into the training group (n = 90) and the validation group (n = 49). The radiologic model and Nomogram model were established by multivariate Logistic regression analysis. Predictive performance was evaluated using receiver operating characteristic (ROC) curves.ResultsA total of 829 features were extracted from CT images of paravertebral muscles, and 12 optimal predictive features were obtained by the mRMR and Lasso feature selection methods. The radiomics model can better predict bone abnormality in type 2 diabetes mellitus, and the (Area Under Curve) AUC values of the training group and the validation group were 0.94(95% CI, 0.90-0.99) and 0.90(95% CI, 0.82-0.98). The combined Nomogram model, based on radiomics and clinical characteristics (vertebral CT values), showed better predictive efficacy with an AUC values of 0.97(95% CI, 0.94-1.00) in the training group and 0.95(95% CI, 0.90-1.00) in the validation group, compared with the clinical model.ConclusionThe combination of Nomogram model and radiomics-clinical features of paravertebral muscles has a good predictive value for abnormal bone mass in patients with type 2 diabetes mellitus.

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Relationship between oseteoporosis with fatty infiltration of paraspinal muscles based on QCT examination

Cited by 8 publications

References 48 publications

Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion

Clinical use of quantitative computed tomography to evaluate the effect of less paraspinal muscle damage on bone mineral density changes after lumbar interbody fusion

Relationship between paraspinal muscle properties and bone mineral density based on QCT in patients with lumbar disc herniation

The value of radiomics to predict abnormal bone mass in type 2 diabetes mellitus patients based on CT imaging for paravertebral muscles

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