Effect of sarcopenia on the mid-term clinical efficacy of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture
10.3760/cma.j.cn115396-20250905-00221
- VernacularTitle:肌少症对经皮椎体成形术治疗骨质疏松性椎体压缩骨折中期临床疗效的影响
- Author:
Ligong CHENG
1
;
Hongchen WANG
;
Yuncheng WANG
;
Wei ZHANG
Author Information
1. 北京市大兴区中西医结合医院骨科，北京 100076
- Keywords:
Thoracic vertebrae;
Lumbar vertebrae;
Fractures, bone;
Vertebroplasty;
Sarcopenia
- From:
International Journal of Surgery
2025;52(11):767-772
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the influence of sarcopenia on the mid-term clinical outcomes of percutaneous vertebroplasty(PVP) in the management of osteoporotic vertebral compression fractures(OVCF).Methods:A retrospective case analysis method was adopted to analyze the clinical data of 102 patients with OVCF who underwent PVP in Beijing Daxing District Hospital of Integrated Chinese and Western Medicine from September 2020 to September 2022. Among them, there were 19 males and 83 females; the patients was (74.31±6.99) years, aged from 61 to 89 years. Using the skeletal muscle index (SMI) at the L3 vertebral level as the basis for grouping, with the diagnostic criteria of SMI<24.4 cm 2/m 2 for males and SMI<23.3 cm 2/m 2 for females. The 102 patients were divided into the sarcopenia group ( n=42) and the non-sarcopenia group ( n=60). The visual analog scale(VAS) scores for low back pain were recorded before surgery and at 3 days, 6 months, 1 year, 3 years after surgery; The oswestry disability index(ODI) was recorded at 6 months, 1 year, and 3 years after surgery; Bone mineral density (BMD) T-scores were recorded at 1 year and 3 years after surgery, and complications such as adjacent vertebral fractures were recorded. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), and comparisons between groups were performed using the t-test. Count data were expressed as case and percentage (%), and comparisons between groups were performed using the chi-square test or Fisher′s exact test. Results:All patients in this study successfully completed the surgery and were followed up for 3 years. Compared with the preoperative baseline levels, the VAS for low back pain and ODI of patients in both groups decreased significantly at all postoperative time points, with statistically significant differences ( P<0.05). For patients in the sarcopenia group, the VAS for low back pain at 3 days, 6 months, 1 year, and 3 years after surgery were (2.50±1.04), (2.45±0.80), (2.17±0.79), (1.90±0.76) points, respectively. Those in the non-sarcopenia group were(2.02±0.68), (1.85±0.80), (1.78±0.61), (1.57±0.62) points, respectively, with a statistically significant difference between the two groups ( P<0.05). The ODI scores of the sarcopenia group at 6 months, 1 year, and 3 years postoperatively were (23.76±3.88)%, (23.05±4.33)%, (22.51±4.49)%, while those of the non-sarcopenia group were (21.68±4.51)%, (20.78±4.60)%, (20.30±4.44)%. The difference between the two groups was statistically significant ( P<0.05). The T-scores of femoral neck bone mineral density in the sarcopenia group at 1 year and 3 years after surgery were (-2.78±0.38), (-2.71±0.41), and those in the non-sarcopenia group were (-2.63±0.35), (-2.53±0.34), with a statistically significant intergroup difference ( P<0.05). For the T-scores of lumbar spine bone mineral density, the sarcopenia group had (-3.36±0.58), (-3.47±0.68) at 1 year and 3 years postoperatively, compared with (-3.12±0.59), (-2.91±0.53) in the non-sarcopenia group. The difference between the two groups was statistically significant ( P<0.05). Regarding the incidence of postoperative complications such as adjacent vertebral fractures, the sarcopenia group had a significantly higher incidence (19.0%) than the non-sarcopenia group (3.3%), with a statistically significant difference between the groups ( P<0.05). Conclusions:OVCF patients with sarcopenia who undergo PVP have poorer mid-term postoperative efficacy than those without sarcopenia, and they also face an increased risk of postoperative complications. Early screening and active intervention for patients with sarcopenia will help improve their clinical efficacy.
