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Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures

Authors :
Ali Shah
Karthikeyan P. Iyengar
Christine Azzopardi
Shahnawaz Haleem
Jwalant Mehta
Rajesh Botchu
Source :
Indian Journal of Radiology and Imaging, Vol 33, Iss 01, Pp 008-011 (2023)
Publication Year :
2023
Publisher :
Thieme Medical and Scientific Publishers Pvt. Ltd., 2023.

Abstract

Background Vertebral insufficiency fractures in the elderly are associated with increased morbidity and mortality. Early diagnosis is essential to direct patient-specific rehabilitation. Aims We hypothesize that in patients with vertebral insufficiency fractures, there is atrophy of the psoas and paraspinal muscles with alteration in the cross-sectional area (CSA) of the muscles. Materials and Methods Magnetic resonance imaging (MRI) studies for 100 consecutive patients, older than 60 years presenting with lower back pain, were included in the study. For each MRI study, the CSA of the psoas and paraspinal muscles (multifidus) at the level of L4/5-disc space was measured to calculate the cross-sectional area ratio (CSAR) by two readers. One reader repeated the measurements after an interval of 2 weeks. We divided the patients (n = 100) into various groups based on the number of vertebral fractures. Results In total, 77 patients with vertebral body fractures (48 with one, 16 with two and 13 with more than two fractures) were identified with a mean age of 73 (range 60–92) years. The ratio of multifidus CSA to psoas CSA was calculated with mean values of each group (1–4) as 2.56, 1.89, 2.09 and 2.16, respectively. There was statistically significance difference of the CSAR between the cohorts (p-value = 0.0115). Conclusion Vertebral insufficiency fractures in the elderly are associated not only with atrophy of psoas and the multifidus group of muscles as evident by the CSA values, but they also affect the CSAR depending on the number of fractures. This finding may help to direct targeted patient-specific physiotherapy rehabilitation and interventions to prevent further such fractures.

Details

Language :
English
ISSN :
09713026, 19983808, and 00421758
Volume :
33
Issue :
01
Database :
Directory of Open Access Journals
Journal :
Indian Journal of Radiology and Imaging
Publication Type :
Academic Journal
Accession number :
edsdoj.2e4d100dd4694c31bbede2a016c98ea2
Document Type :
article
Full Text :
https://doi.org/10.1055/s-0042-1758522