Background: Vertebral compression fractures associated with osteoporosis reduce daily living activities. The primary risk factor for osteoporotic vertebral fractures (OVCFs) is the severity of osteoporosis, defined as low bone mineral density (BMD) in both peripheral and central regions. In addition to BMD, sarcopenia is also thought to affect OVCFs by reducing paraspinal muscle mass and strength. Objective: We aimed to evaluate the association between vertebral compression fractures and paraspinal/psoas muscle characteristics, including muscle mass and fatty degeneration, using quantitative MRI measurements. Methods: We retrospectively enrolled 77 patients aged ≥60 years who were diagnosed with acute OVCF between January 2019 and August 2023. The control group consisted of age- and sex-matched patients with osteoporosis (BMD > −2.5) who were followed up without fractures for at least six months. Demographic characteristics, relative total cross-sectional area (rTCSA) and relative functional CSA (rFCSA) of the multifidus (MF), erector spinae (ES), and psoas major (PS) were measured at the L4–5 and L5-S levels on MRI. Results: The TCSA and rTCSA of the multifidus (MF) and erector spinae (ES) muscles at both the L4-5 and L5-S1 levels did not show significant differences between the control and OVCF groups. (all p value > 0.05) The mean FCSAL4-5 of the MF 8.97 ± 2.81, ES 16.73 ± 6.49, the mean FCSAL5-1 of the MF 9.43 ± 3.27, ES 10.76 ± 5.79 in the fracture group, while the mean FCSAL4-5 of the MF 11.39 ± 2.6, ES 19.35 ± 4.04, the mean FCSAL5-1 of the MF 13.42 ± 2.56, ES 14.11 ± 4.6 in the non-fracture group. (PMFL4-5 < 0.001, PMFL5-1 < 0.001, PESL4-5 = 0.003, PESL5-1 < 0.001) The mean TCSA of the psoas muscle was significantly higher in the fracture group (17.65 ± 6.21) than in the control group (15.9 ± 4.14) (p = 0.042). Despite the significantly larger total psoas muscle mass in the fracture group, the rFCSA of the psoas muscle was lower in the fracture group (0.81 ± 0.27) compared to the control group (0.89 ± 0.25) (p = 0.046). Conclusions: The study shows that the functional muscle mass of the paraspinal muscles is significantly lower in patients with osteoporotic vertebral compression fractures (OVCF) as compared to those without fractures. Quantitative measurement of the functional capacity of the paraspinal muscles using MRI can effectively predict the risk of OVCF and enable early intervention and adopt preventive measures to reduce the incidence of these fractures.

Osteoporotic vertebral compression fractures (OVCF) are a common complication of osteoporosis, particularly in elderly populations. Percutaneous kyphoplasty (PKP) is a minimally invasive procedure that provides pain relief and spinal stability for patients with OVCF. However, new vertebral compression fractures (NVCF) can occur in 2% to 38% of patients following PKP, posing a significant clinical challenge. Identifying risk factors for NVCF is essential to improve patient outcomes and guide preventive strategies. A retrospective study was conducted on 193 patients aged 60 years or older who underwent PKP for OVCF at a tertiary hospital between January 2017 and December 2023. Patients were divided into 2 groups based on the occurrence of NVCF during follow-up. Preoperative imaging (CT, X-ray, and MRI) and hospital records were analyzed to assess risk factors, including age, gender, bone mineral density, Hounsfield unit (HU) values, paraspinal muscle degeneration, cement volume, and leakage. Statistical analyses were performed using SPSS software, with multivariate regression analysis identifying independent predictors of NVCF. Among the 193 patients, 23.3% (n = 45) developed NVCF during follow-up, while 76.7% (n = 148) did not. Lower HU values (mean 58.1 ± 18.68 vs 79.5 ± 25.44, P = .0001) and increased fatty infiltration of paraspinal muscles were identified as significant independent risk factors for NVCF. Multivariate regression analysis confirmed lower HU values (OR = 0.965, P < .001) and fatty infiltration of the erector spinae muscle (OR = 1.034, P = .038) as predictors. Other factors, such as age, gender, bone mineral density, cement volume, and leakage, were not significantly associated with NVCF. Lower HU values and paraspinal muscle degeneration, particularly reduced functional muscle mass and increased fatty infiltration, are significant predictors of NVCF following PKP. Preoperative evaluations should include HU measurements and paraspinal muscle assessments to identify high-risk patients. Postoperative management should focus on improving bone density and muscle health through targeted therapies and lifestyle modifications to reduce fracture risk.

Background and Study Aims Spinal cord injury (SCI) is one of the most complicated pathologies that affect active young males. miR-21 primarily regulates several cellular processes. We aimed to elucidate the regulatory role of miR-21 and test methylprednisolone as a disease-modifying agent on experimental SCI tissues. Methods A total of 36 8- to 10-week-old adult female Sprague-Dawley rats weighing 250 to 300 g were used. Animals were randomly divided into six groups. Except for groups 1 and 4, the spinal trauma model was applied to all animal groups using the clipping method. In groups 3 and 6, methylprednisolone was given. For real-time polymerase chain reaction (PCR) investigations, rats in groups 1, 2, and 3 were reoperated on after the first postoperative day, whereas those in groups 4, 5, and 6 were reoperated on after postoperative day 7 and spinal cord samples from the laminectomy area were removed for gene expression analysis. Relative gene expression of miR-21, Gfap, Vim, Stat3, Faslg, Pten, Bax, Bcl2, Cox2, and Il6 were determined with quantitative reverse transcription (qRT) PCR. Results In group 3, the miR-21 expression significantly increased compared with groups 1 and 2. When compared with group 3, a decrease in miR-21 expression was observed in group 6 (p < 0.05). When compared with group 4, group 6 had lower levels of Gfap, Pten, Stat3, and Bax (p < 0.05). Conclusions miR-21 supports the beneficial aspects of the body's healing mechanisms following SCI. In the acute phase, the use of methylprednisolone increases miR-21 expression in the early period of trauma. Methylprednisolone increases some astrogliosis and inflammation biomarkers' levels; however, it did not affect the apoptotic biomarkers.

Background/Objectives: Spontaneous intracranial hemorrhage (sICH) is a life-threatening condition with high in-hospital mortality rates. Prognostic evaluation remains challenging, and biomarkers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), glucose-to-lymphocyte ratio (GLR), and high-sensitivity troponin-I (hs-cTn-I) have been studied for their potential prognostic significance. This study aimed to evaluate the role of hs-cTn-I, NLR, PLR, LMR, and hematoma volume in predicting prognosis in sICH patients. Methods: This retrospective study included 49 adult patients (>18 years) admitted between January 2021 and January 2024 with sICH and hematoma volume >30 mL. All patients underwent surgery within 24 h of admission. Laboratory data, including hs-cTn-I levels and hematological indices, were collected. The hematoma volume was measured using the ABC/2 method. Patients were divided into survival and mortality groups. Statistical analyses were performed using SPSS, with p < 0.05 considered significant. Results: Of the 49 patients, 24 (49%) died. Admission hs-cTn-I levels showed no significant difference between groups, but levels on days 7 and 30 were significantly higher in the mortality group (p < 0.001). ROC analysis revealed hs-cTn-I levels on day 30 had better prognostic performance (AUC: 0.89, cut-off: 46 ng/mL, sensitivity: 76%, specificity: 88%). The hematoma volume and admission hematological indices (NLR, PLR, LMR, SII, and GLR) were not significantly associated with prognosis. Conclusions: Elevated hs-cTn-I levels, particularly on days 7 and 30, were significant predictors of in-hospital mortality in sICH patients. While admission hematological indices and hematoma volume lacked prognostic value, hs-cTn-I may serve as a valuable biomarker for risk stratification in clinical practice. Further multicenter studies with larger cohorts and multivariate analyses are needed to validate these findings.