Comprehensive Diagnostic Value of Vertebral Bone Quality Scores and Paravertebral Muscle Quality Parameters in Osteoporotic Vertebral Fractures.

Abstract

Both vertebral bone quality (VBQ) scores and paravertebral muscle quality can predict osteoporotic vertebral fractures (OVFs). This study aimed to compare the diagnostic value of opportunistic VBQ scores and sarcopenia for OVF and to determine if their combined use could enhance diagnostic efficacy. A total of 194 patients, matched 1:1 by age and sex, were included. VBQ scores and paravertebral muscle cross-sectional areas (CSAs) were measured from lumbar magnetic resonance imaging. Independent risk factors for OVF were determined using multivariate conditional logistic regression. The predictive value of VBQ and muscle-related parameters for OVF were assessed with receiver operating characteristic curves. VBQ, CSA, and degree of fat infiltration (DFF) showed significant differences between the fracture and nonfracture groups (P < 0.001). Multivariate analysis identified lower multifidus (MF) CSA, higher MF DFF, and higher VBQ as independent risk factors for OVF. Thresholds of 3.46 for VBQ and 11.83 cm² for MF CSA yielded area under the curve values of 0.668 and 0.736, respectively, for predicting OVF. Combining VBQ and MF CSA notably enhanced the sensitivity and specificity of OVF diagnosis. The predictive value of MF CSA in anticipating OVF was marginally superior to that of VBQ and MF DFF. Furthermore, the concurrent utilization of VBQ and MF CSA substantially enhanced the diagnostic accuracy of OVF. Considering that both VBQ and MF CSA can be opportunistically obtained during routine examinations, individuals with a VBQ ≥3.46 and MF CSA ≤11.83 cm² should be categorized as high risk for OVF, warranting timely preventive measures.