PSOAS AND SACROSPINALIS MUSCLE SIZE AND DENSITY: AN INDICATOR OF FALL RISK IN THE GERIATRIC POPULATION

Purpose (a): The sequlae of fragility fractures continue to be a major source of morbidity and mortality, as well as a contributing factor in the rising cost of healthcare. The risks of fragility fracture are multifactorial with the current screening paradigm focused on detecting and treating decreased bone mineral density. Physiologic aging is associated with sarcopenia, and decreasing muscle mass has also been described as an independent risk factor for fragility fracture. This study hypothesized that the observed cross sectional area of the psoas and sacrospinalis muscles would be smaller in patients who developed fragility fractures. Methods (b): To test this hypothesis we performed a retrospective chart review comparing the cross sectional area of Illiopsoas and Sacrospinalis muscles in 145 patients over 50 years of age with fragility fractures compared with 55 controls (patients over age 50 undergoing CT scan for cholelithiasis). Results (c): We found that the population of patients admitted with femoral neck fractures had significantly smaller illiopsoas and sacrospinalis cross sectional areas than controls (P < 0.05). Conclusions (d): The study identifies a quantifiable independent risk factor for fragility fracture that is not currently included in standard screening protocols. Future prospective work will seek to verify if psoas and sacrospinalis muscle morphology is predictive of fracture risk. Ultimately a more predictive multifactorial model of fragility factor risk may be developed that includes screening for both osteoporosis and sarcopenia.