• Song Wang, Le Liu, Hao Liu, Xiang Zhang, Honglin Liao, Ping He, Hao Yang, Hongsheng Yang, and Bo Qu.
• School of clinical medicine, Chengdu Medical College, Chengdu, China.
• World Neurosurg. 2024 Dec 10; 194: 123503123503.

ObjectiveBoth 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.MethodsA 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.ResultsVBQ, 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.ConclusionsThe 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.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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