J Bone Metab.  2013 Nov;20(2):75-81. 10.11005/jbm.2013.20.2.75.

Changes of Paraspinal Muscles in Postmenopausal Osteoporotic Spinal Compression Fractures: Magnetic Resonance Imaging Study

• Kim JY
• Chae SU
• Kim GD
• Cha MS

• KMID: 2286297
• DOI: http://doi.org/10.11005/jbm.2013.20.2.75

Abstract

BACKGROUND
To investigate the changes of cross sectional area (CSA) in paraspinal muscles upon magnetic resonance imaging (MRI) and bone mineral density (BMD) in postmenopausal osteoporotic spinal compression fractures.
METHODS
We reviewed 81 postmenopausal women with osteoporosis, who had underwent MRI examination. The patients were divided into 51 patients who had osteoporotic spinal compression fractures (group I), and 30 patients who without fractures (group II). Group I were subdivided into IA and IB, based on whether they were younger (IA) of older (IB) than 70 years of age. We additionally measured body mass index and BMD. The CSA of multifidus, erector spinae, paraspinal muscles, psoas major (PT), and intervertebral (IV) discs were measured. The degree of fatty atrophy was estimated using three grades.
RESULTS
The BMD and T-score of group I were significantly lower than those of group II. The CSA of erector spinae, paraspinal muscles, and PT in the group I was significantly smaller than that of group II. The CSA of paraspinal muscles in group IB were significantly smaller than those of group IA. The CSA of erector spinae, mutifidus, and PT in group IB were smaller than those of group IA, but the difference was not statistically significant. Group 1 exhibited greater fat infiltration in the paraspinal muscle than group II.
CONCLUSIONS
Postmenopausal osteoporotic spinal compression fracture is associated with profound changes of the lumbar paraspinal muscle, reduction of CSA, increased CSA of IV disc, and increased intramuscular fat infiltration.

Keyword

Cross-sectional area; Fractures compression; Paraspinal muscles; Postmenopause

MeSH Terms

Atrophy
Body Mass Index
Bone Density
Female
Fractures, Compression*
Humans
Magnetic Resonance Imaging*
Magnetics*
Magnets*
Muscles*
Osteoporosis
Postmenopause
Psoas Muscles

Figure

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  Fig. 1 Magnetic resonance axial image shows cross section of the muscles at L4/5 disc level. IV Disc: L4/5 intervertebral disc, moment arm length of the erector spinal muscle.

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  Fig. 2 MR axial images demonstrating fat infiltration in the lumbar paraspinal muscles. (A) normal (B) mild fatty atrophy of paraspinal muscles (C) moderate fatty atrophy of paraspinal muscles (D) severe fatty atrophy of paraspinal muscles.

• 

  Fig. 3 The number of patients of each fat infiltration grade in the paraspinal muscle of each group. Pts, patients.

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