Lumbar localized fat distribution parameters are independent predictors of osteoporotic vertebral compression re-fractures (OVCRFs) following Percutaneous Kyphoplasty (PKP): a retrospective matched case-control study

Fu-Yu Zhang; Lei Zhu; Hang Shi; Feng Wang; Lu Chen; Zi-Jian Zhang; Zan-Li Jiang; Jie Yao; Xiao-Tao Wu

doi:10.1007/s00256-024-04815-z

Lumbar localized fat distribution parameters are independent predictors of osteoporotic vertebral compression re-fractures (OVCRFs) following Percutaneous Kyphoplasty (PKP): a retrospective matched case-control study

Skeletal Radiol. 2024 Oct 12. doi: 10.1007/s00256-024-04815-z. Online ahead of print.

Authors

Fu-Yu Zhang^#^{1

2}, Lei Zhu^#^{1

2}, Hang Shi^{1

2}, Feng Wang^{1

2}, Lu Chen^{1

2}, Zi-Jian Zhang^{1

2}, Zan-Li Jiang^{1

2}, Jie Yao³, Xiao-Tao Wu^{4

5}

Affiliations

¹ Southeast University Medical College, Nanjing, China.
² Department of Spine Surgery, Southeast University Zhongda Hospital, Nanjing, 210009, China.
³ National Healthy Commission Contraceptives Adverse Reaction Surveillance Center/Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment/Jiangsu Health Development Research Center, Nanjing, 210009, China. 395605757@qq.com.
⁴ Southeast University Medical College, Nanjing, China. wxt_spine2024@163.com.
⁵ Department of Spine Surgery, Southeast University Zhongda Hospital, Nanjing, 210009, China. wxt_spine2024@163.com.

^# Contributed equally.

PMID: 39394355
DOI: 10.1007/s00256-024-04815-z

Abstract

Objective: To investigate potential risk factors for osteoporotic vertebral compression re-fractures (OVCRFs) following percutaneous kyphoplasty (PKP).

Materials and methods: Patients who underwent PKP from January 2012 to January 2020 were included in this study within the same institution. Cases were defined as patients who experienced OVCRFs, while controls were matched based on corresponding clinical characteristics from those patients without OVCRFs. The lumbar localized fat distribution parameters, including the fat infiltration ratio (FIR) in muscles [multifidus (MF), erector spinae (ES), paravertebral muscles (PVM), and psoas major (PS)] and subcutaneous fat thickness (SFT), were compared between the two groups through radiological data. And other clinical data that may be relevant were also compared. Independent risk factors for OVCRFs after PKP were identified through a binary logistic regression analysis.

Result: A total of 1391 patients who underwent PKP were included in this study. 51 patients were categorized into the re-fracture group, and 102 patients were selected as matched controls from the remaining cohort. There were statistically significant differences between the two groups in metrics including MF-FIR, ES-FIR, PVM-FIR, PS-FIR, bone mineral density (BMD), body-mass index (BMI), SFT, hemoglobin (Hb), albumin (ALB), alkaline phosphatase (ALP), and triglycerides (TG) (P < 0.05). Binary logistic regression analysis demonstrated that PVM-FIR (P = 0.003), SFT (P < 0.001), BMD (P = 0.011), and ALP (P = 0.005) were independent predictors for the occurrence of OVCRFs.

Conclusion: This study discovered that lumbar localized fat distribution parameters including PVM-FIR and SFT are independent predictors of OVCRFs. Additionally, BMD and ALP were found to be independent predictors of OVCRFs.

Keywords: Fat infiltration; MRI; Muscle; Osteoporotic vertebral compression fracture; Percutaneous kyphoplasty; Re-fracture; Subcutaneous fat thickness.

Abstract

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