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Abstract：
The correlation between lower psoas mass and the prognosis of osteoporotic vertebral compression fractures (OVCF) is still unclear. This study aims to investigate the impact of lower psoas mass on the prognosis of patients undergoing percutaneous vertebroplasty (PVP). One hundred and sixty-three elderly patients who underwent single-segment PVP from January 2018 to December 2021 were included. The psoas to L4 vertebral index (PLVI) via MRI were measured to assess psoas mass. Patients were divided into high PLVI (> 0.79) and low PLVI (≤ 0.79) groups based on the median PLVI in the cohort. The basic information (age, gender, body mass index (BMI) and bone mineral density (BMD)), surgical intervention-related elements (duration of operation, latency to ambulation, period of hospital stay, and surgical site), postoperative clinical outcomes (Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) scores, Japanese Orthopaedic Association (JOA) scores), and incidence of secondary fractures) were compared. Patients showed no statistically significant differences in terms of age, gender, surgical sute, BMI, BMD and preoperative VAS, ODI, JOA scores (P > 0.05) between the two groups. However, there were significant differences in terms of latency to ambulation, period of hospital stay (P < 0.05). VAS, ODI, and JOA scores at 1, 6, and 12 months after surgery showed that the high PLVI group had significantly better outcomes than the low PLVI group (P < 0.05). Additionally, the low PLVI group had a significantly higher incidence of recurrent fracture (P < 0.05). Lower psoas mass can reduce the clinical effect of PVP in patients with osteoporotic vertebral compression fractures, and is a risk factor for recurrent vertebral fracture.
摘要：
腰大肌下段与骨质疏松性椎体压缩骨折(OVCF)预后的相关性尚不清楚。本研究旨在探讨腰大肌下段肿块对经皮椎体成形术(PVP)患者预后的影响。纳入了从2018年1月至2021年12月接受单段PVP的163名老年患者。通过MRI测量腰大至L4椎体指数（PLVI）以评估腰大肌质量。根据队列中的PLVI中位数将患者分为高PLVI（>0.79）和低PLVI（≤0.79）组。基本信息(年龄，性别,体重指数（BMI）和骨密度（BMD），手术干预相关因素(手术持续时间，移动延迟，住院期间,和手术部位)，术后临床结果(视觉模拟量表(VAS)评分，Oswestry残疾指数（ODI）得分，日本骨科协会（JOA）评分），和继发性骨折的发生率）进行比较。患者在年龄方面没有统计学上的显著差异，性别,外科苏特，BMI,BMD和术前VAS,ODI,两组间JOA评分比较(P>0.05)。然而,在步行潜伏期方面存在显着差异，住院时间(P<0.05)。VAS,ODI,术后1、6和12个月的JOA评分显示，高PLVI组的预后明显优于低PLVI组（P<0.05）。此外,低PLVI组骨折复发发生率明显高于对照组(P<0.05)。下腰大肌肿块可降低PVP治疗骨质疏松性椎体压缩性骨折患者的临床效果,并且是复发性椎骨骨折的危险因素。
