Abstract
Introduction: This study aimed to examine factors associated with poor outcomes in osteoporotic vertebral fracture (OVF) treatment; medical complications and decreased activities of daily living (ADL) at discharge.
Methods: We retrospectively studied 144 consecutive inpatients with thoracolumbar vertebral fractures in our hospital and statistically investigated factors associated with medical complications and decreased ADL at discharge for treating OVFs. The clinical course of OVF, presence of medical complications during bed rest, ADL evaluation, bone mineral density, and lumbar spine X-ray and MRI images were investigated in 129 patients with 151 vertebral bodies after excluding 15 patients with diffuse idiopathic skeletal hyperostosis-related fractures. Lumbar spine MRI images were used to measure the cross-sectional area of the paraspinal and psoas major muscles and evaluate fatty degeneration according to the Goutallier classification.
Results: Of the 129 patients, 4 underwent surgery. Medical complications were observed in 27 cases, and multivariate analysis showed that emergency transport and low body mass index were independently associated factors. Of the 95 patients with preinjury ADLs of walking with a cane or better, 38 had decreased ADLs at discharge, and multivariate analysis showed that paraspinal fatty degeneration was an independent associated factor.
Conclusions: Evaluation of fatty degeneration of paraspinal muscles might be useful for predicting ADL in patients with OVF, and medical or social intervention for high-risk cases of ADL decline should be considered.
