Cargando…

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

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Shah, Ali, Iyengar, Karthikeyan P., Azzopardi, Christine, Haleem, Shahnawaz, Mehta, Jwalant, Botchu, Rajesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968526/
https://www.ncbi.nlm.nih.gov/pubmed/36855732
http://dx.doi.org/10.1055/s-0042-1758522
_version_ 1784897522796331008
author Shah, Ali
Iyengar, Karthikeyan P.
Azzopardi, Christine
Haleem, Shahnawaz
Mehta, Jwalant
Botchu, Rajesh
author_facet Shah, Ali
Iyengar, Karthikeyan P.
Azzopardi, Christine
Haleem, Shahnawaz
Mehta, Jwalant
Botchu, Rajesh
author_sort Shah, Ali
collection PubMed
description 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.
format Online
Article
Text
id pubmed-9968526
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format MEDLINE/PubMed
spelling pubmed-99685262023-02-27 Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures Shah, Ali Iyengar, Karthikeyan P. Azzopardi, Christine Haleem, Shahnawaz Mehta, Jwalant Botchu, Rajesh Indian J Radiol Imaging 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. Thieme Medical and Scientific Publishers Pvt. Ltd. 2022-11-24 /pmc/articles/PMC9968526/ /pubmed/36855732 http://dx.doi.org/10.1055/s-0042-1758522 Text en Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Shah, Ali
Iyengar, Karthikeyan P.
Azzopardi, Christine
Haleem, Shahnawaz
Mehta, Jwalant
Botchu, Rajesh
Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures
title Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures
title_full Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures
title_fullStr Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures
title_full_unstemmed Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures
title_short Alteration in the Cross-sectional Area (CSA) Ratio of the Paraspinal Muscles following Vertebral Insufficiency Fractures
title_sort alteration in the cross-sectional area (csa) ratio of the paraspinal muscles following vertebral insufficiency fractures
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968526/
https://www.ncbi.nlm.nih.gov/pubmed/36855732
http://dx.doi.org/10.1055/s-0042-1758522
work_keys_str_mv AT shahali alterationinthecrosssectionalareacsaratiooftheparaspinalmusclesfollowingvertebralinsufficiencyfractures
AT iyengarkarthikeyanp alterationinthecrosssectionalareacsaratiooftheparaspinalmusclesfollowingvertebralinsufficiencyfractures
AT azzopardichristine alterationinthecrosssectionalareacsaratiooftheparaspinalmusclesfollowingvertebralinsufficiencyfractures
AT haleemshahnawaz alterationinthecrosssectionalareacsaratiooftheparaspinalmusclesfollowingvertebralinsufficiencyfractures
AT mehtajwalant alterationinthecrosssectionalareacsaratiooftheparaspinalmusclesfollowingvertebralinsufficiencyfractures
AT botchurajesh alterationinthecrosssectionalareacsaratiooftheparaspinalmusclesfollowingvertebralinsufficiencyfractures