骨质疏松性腰椎压缩性骨折的椎间盘和椎旁肌肉MRI变化及意义

MRI changes of intervertebral disc and paravertebral muscle in osteoporotic lumbar vertebral compression fracture and its significance

目的研究骨质疏松性腰椎压缩性骨折的椎间盘、椎旁肌肉磁共振成像(MRI)变化及意义。方法回顾性分析我院85例腰椎压缩性骨折患者的临床资料,将45例存在骨质疏松的患者纳入观察组,40例无骨质疏松的患者纳入对照组。比较2组患者的Pfirrmann分级、L_(1)~L_(5)椎旁肌肉的相关指标,包括双侧多裂肌横截面积、双侧竖脊肌横截面积、椎体横截面积、脂肪变性比例。结果2组Pfirrmann分级比较,差异有统计学意义(P<0.05)。对照组L_(1)~L_(5)双侧多裂肌横截面积、双侧竖脊肌横截面积显著大于观察组,L_(1)~L_(5)脂肪变性比例显著低于观察组,差异均有统计学意义(P<0.05);2组L_(1)~L_(5)椎体横截面积比较,差异无统计学意义(P>0.05)。结论骨质疏松性腰椎压缩性骨折患者的腰椎间盘退变程度明显高于单纯腰椎压缩性骨折患者,其椎旁肌肉MRI变化主要表现为双侧多裂肌、竖脊肌横截面积减小和脂肪变性比例升高。

Objective To study the changes and significance of magnetic resonance imaging(MRI)of intervertebral disc and paravertebral muscle in osteoporotic lumbar vertebral compression fracture.Methods The clinical data of 85 patients with lumbar compression fracture in our hospital were retrospectively reviewed.A total of 45 patients combined with osteoporosis were included in the observation group,and 40 patients without osteoporosis were included in the control group.The Pfirrmann grading and related indexes of paravertebral muscles from L_(1) to L_(5) including cross-sectional area of bilateral multifidus muscle,cross-sectional area of bilateral erector spinae,cross-sectional area of vertebral body and steatosis ratio were compared between the two groups.Results There was significant difference in the Pfirrmann grading between the two groups(P<0.05).The cross-sectional areas of bilateral multifidus muscle and bilateral erector spinae from L_(1) to L_(5) in the control group were significantly greater than those in the observation group,and the steatosis ratios from L_(1) to L_(5) were significantly lower than those in the observation group,with statistically significant differences(P<0.05).There was no significant difference in the cross-sectional area of vertebral bodies from L_(1) to L_(5) between the two groups(P>0.05).Conclusion Compared with patients with simple lumbar compression fracture,patients with osteoporotic vertebral compression fracture have significantly higher degenerative degree of lumbar intervertebral disc,whose MRI changes of paraspinal muscles are mainly manifested as the decrease of cross-sectional areas of bilateral multifidus muscle andbilateral erector spinae and the increase of steatosis ratio.