Multivariate Analysis Of Osteoporotic Vertebral Compression Fractures And Sarcopenia

Background:Osteoporosis(OP)mostly occurs in the elderly and postmenopausal women.It is caused by various reasons for the decline of bone density and bone mass,increased bone fragility and degenerative changes in ultra-structure.Due to endocrine and metabolism disorders,increased bone absorption,decreased osteogenesis and other types of degradation,many complications occur,such as pain,fractures,spinal deformation,etc.The most dangerous complications caused by OP are fractures,including hip fractures,spine fractures,and distal ulna and radius fractures,among which hip fractures are one of the fractures with the highest risk of death.The spine is the axial bone of the human body,which supports the body and is prone to osteoporosis.Therefore,Osteoporotic Vertebral Compression Fracture(OVCF)often occurs.Fractures can cause pain,spinal deformities,and further cause chronic pain,decreased pulmonary function,and decreased muscle mass.In order to avoid complications,conservative treatment includes bed-rest immobilization,external fixation,and anti-inflammatory analgesics.For most OVCF,a single conservative treatment cannot effectively delay the progression of the disease.Therefore,surgery is advocated as the main treatment for OVCF.Surgical methods include percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP).PVP and PKP surgery are minimally invasive,the operation time is short,the operation under local anesthesia,the rapid relief of pain and the ability to get out of bed early,are widely used in the treatment of OVCF.Purpose:The purpose of this study is to collect the data of OVCF patients who underwent PVP and PKP,and divide them into sarcopenia group and non-sarcopenia group according to the diagnostic criteria of sarcopenia,statistically analyze the patients in each subgroup,and Look for possible risk factors for OVCF combined with sarcopenia.Record the patient’s age,body mass index(BMI),Methods:We assessed patients with Osteoporotic Vertebral Compression Fracture who met the selection criteria and were admitted to QiLu Hospital from October 2018 to October 2020.In order to facilitate the diagnosis of sarcopenia,the cross-sectional computed tomography(CT)image of the middle part of the third lumbar vertebra(L3)is displayed to measure the muscle cross-sectional area to assess muscle mass.At the same time,measure the cross-sectional area of the small paravertebral muscles on the left and right sides of the plane to evaluate the relationship between the paravertebral muscles and sarcopenia.An electronic grip dynamometer is used to measure the grip strength to evaluate muscle strength.Assess related factors such as age,gender,age at menopause,body mass index,bone mineral density(BMD),bone turnover markers(BTMs),BTMs including parathyroid hormone(PTH),vitamin D,N-terminal osteocalcin(N-MIDOs),β-collagen degradation products(β-CROS),total type I collagen N-terminal extension(T-PINT).Through preoperative blood test,the patient’s hemoglobin content and albumin content were obtained.To assess the relationship between blood indicators in patients with sarcopenia and non-sarcopenia.Results:According to the patient’s medical history,imaging,clinical symptoms,physical examination and hematology screening,patients who did not meet the criteria were excluded,and 117 OVCF patients were finally included.The age ranged from 62 to 78 years,with an average age of 68.92±9.02 years.Among them,30 were sarcopenia patients(25.6%)and 87 were non-sarcopenia patients(74.4%).In univariate analysis,lower BMI,lower lumbar spine MBD,lower left hip BMD,lower L3 mid-section CT bilateral psoas major muscle area,lower L3 mid-sect ion CT bilateral psoas major muscle area,lower L3 mid-segment CT bilateral quadratus lumborum area,lower PTH,and higher length of hospital stay are associated with sarcopenia.Conclusion:Sarcopenia has become a frequently-occurring disease in the elderly.The use of PVP,PKP and other surgical treatments to treat OVCF patients with rare symptoms can benefit patients.The decrease in skeletal muscle content can be accompanied by lower bone density.In OVCF patients,higher hospital stays and lower PTH,as well as the cross-sectional area of L3 interrupted small muscles may be used as risk factors for predicting sarcopenia.