Fatty infiltration of multifidus muscle independently increases osteoporotic vertebral compression fracture risk

Abstract

Abstract Background Vertebral compression fractures decrease daily life activities and increase economic and social burdens. In addition, sarcopenia and back muscle atrophy influence osteoporotic vertebral compression fractures (OVCF). Therefore, this study aimed to evaluate the influence of the multifidus muscle on the OVCF. Methods We retrospectively recruited the study population based on the hospital database following the inclusion and exclusion criteria. The inclusion criteria were: 1) ≥ 60 years and 2) concurrent bone mineral density (BMD) and lumbar spine magnetic resonance imaging (MRI). The exclusion criteria were: 1) a history of lumbar spinal surgery, 2) lumbar spine metastasis, and 3) systemic diseases affecting bone density, including chronic renal failure and liver cirrhosis. The participants were divided into three groups based on lumbar spine BMD and OVCF. The control group underwent BMD and spinal MRI evaluation but not OVCF. Based on the T-score of lumbar spine BMD, the fracture groups with OVCF were divided into osteopenia and osteoporosis groups. Osteopenia BMD groups showed osteopenia T-scores of spinal BMD of over − 2.5. Osteoporosis BMD groups also showed osteoporosis T-scores of lumbar BMD of -2.5 and below. Results We included 120 patients who had visited our hospital. Based on spinal MRI, 75 participants were diagnosed with OVCF, and 45 were not. Age, BMD, and the psoas index significantly differed between the control and fracture groups. Moreover, fatty infiltration of the multifidus muscle indifferently affected the OVCF, with and without adjusting for other significant factors. Conclusions The severity of fatty infiltration of the multifidus muscle increases the risk of a spinal fracture. Therefore, preserving the quality of the spinal muscle and bone density is essential for preventing OVCF.