The Role of Trunk Musculature in Osteoporotic Vertebral Fractures: Implications for Prediction, Prevention, and Management.

This review examines the current evidence for associations between vertebral fractures (VFx), the most common type of fracture in older adults, and trunk muscles, which are intimately tied to spinal loading and function. Individuals with prevalent VFxs have more fat infiltration in the trunk muscles, lower trunk extension strength, and altered muscle activation patterns. However, no longitudinal studies have examined whether assessment of trunk muscle can contribute to prediction of fracture risk. A few studies report that exercise interventions targeting the trunk muscles can reduce the risk of VFx, improve trunk strength and endurance in patients who have had a VFx, and reduce the risk of falling, a common cause of VFx, but the quality of evidence is low. Trunk muscles likely have an important role to play in prediction, prevention, and management of VFx, but additional longitudinal studies and randomized controlled trials are needed to clarify this role.