To investigate the association between the degeneration of the multifidus muscle and the severe deformationof osteoporotic vertebral compression fracture (OVCF) utilizing magnetic resonance imaging (MRI) parameters.

From January 2021 to December 2022, a total of 156 OVCF patients were selected and included in this study. Clinical and MRI imaging data were collected and analyzed. The German Orthopedic Trauma Association had proposed a new classification standard for OVCF, and we defined OF1 and OF2 as the slightly compressed group, and OF3-OF5 as the severely compressed group. Univariate and multivariate logistic regression analysis were employed to identify risk factors predictive of OVCF severity.

The study divided participants into slightly compressed (65 patients) and severely compressed groups (91 patients), finding no significant differences in baseline characteristics between them. Statistically significant differences identified through univariate analysis included relative Cross-Sectional Area (rCSA%) of the multifidus muscle (70.12±7.99 vs. 67.45±7.74, t=2.093, P=0.038); relative Effective Functional Area (rEFA%) of the multifidus muscles (42.03 ± 7.64 vs. 35.31±8.16, t=5.202, P<0.001); and Degree of Fatty Infiltration (DFI%) of the multifidus muscle(52.26±7.45 vs. 55.51±7.28, t=2.724, P=0.007). Multivariate logistic regression analysis revealed that rEFA% (P<0.001, OR=0.906, 95% CI [0.863, 0.950]) and DFI% (P=0.029, OR=1.055, 95% CI [1.006, 1.107]) of the multifidus muscle served as independent predictors for the severe deformation of OVCF.

Atrophy and fat infiltration of the multifidus muscle were important feature for degeneration and dysfunction, serving as independent influencing factors for the severity of OVCF. A regular multifidus muscle exercise regimen can effectively slow down the degeneration of multifidus muscles, thereby reducing the likelihood of severe OVCF.