Ohyama Shoichiro, Hoshino Masatoshi, Terai Hidetomi, Toyoda Hiromitsu, Suzuki Akinobu, Takahashi Shinji, Hayashi Kazunori, Tamai Koji, Hori Yusuke, Nakamura Hiroaki
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan.
Eur Spine J. 2019 Sep;28(9):1929-1936. doi: 10.1007/s00586-019-06066-2. Epub 2019 Jul 17.
To clarify the relationship between sarcopenia and spinopelvic parameters.
Among outpatients of spine surgery department, 126 patients (mean age 77.2 years. M/F = 71/55) were included. We diagnosed patients with sarcopenia using the diagnostic algorithm of the Asian Working Group for Sarcopenia. Spinopelvic parameters and the prevalence of spinopelvic mismatch (pelvic incidence minus lumbar lordosis ≥ 10°) were investigated and compared between patients with and without sarcopenia. Furthermore, we compared the spinopelvic parameters between the Sarcopenia and No Sarcopenia groups under each condition of spinopelvic match and mismatch.
The prevalence of sarcopenia in this study was 21.4%. Overall, the spinopelvic parameters except thoracic kyphosis (TK) (Sarcopenia: 34.7°, No Sarcopenia: 24.3°, p < 0.01) were not significantly different between the Sarcopenia and No Sarcopenia groups. Prevalence of patients with spinopelvic mismatch was also not significantly different between the Sarcopenia and No Sarcopenia groups (37.0% vs. 42.4%, p = 0.66). Among patients without spinopelvic mismatch, there was no spinopelvic parameter with a significant difference between the 2 groups. However, among patients with spinopelvic mismatch, sagittal vertebral axis (SVA) (115.7 mm vs. 58.7 mm, p < 0.01) and TK (36.6° vs. 21.3°, p < 0.01) of the Sarcopenia group were significantly larger than those of the No Sarcopenia group. Moreover, sarcopenia was independently related to a significant increase in SVA (β = 50.7, p < 0.01) and TK (β = 14.0, p < 0.01) in patients with spinopelvic mismatch, after adjustment for age.
Sarcopenia is related to spinal sagittal imbalance because of insufficient compensation by flattening thoracic kyphosis in patients with spinopelvic mismatch. These slides can be retrieved under Electronic Supplementary Material.
阐明肌肉减少症与脊柱骨盆参数之间的关系。
纳入脊柱外科门诊患者126例（平均年龄77.2岁，男/女 = 71/55）。我们采用亚洲肌肉减少症工作组的诊断算法诊断肌肉减少症患者。研究并比较了有和没有肌肉减少症患者的脊柱骨盆参数以及脊柱骨盆失配（骨盆入射角减去腰椎前凸≥10°）的患病率。此外，我们比较了脊柱骨盆匹配和失配每种情况下肌肉减少症组和非肌肉减少症组之间的脊柱骨盆参数。
本研究中肌肉减少症的患病率为21.4%。总体而言，除胸椎后凸（TK）外（肌肉减少症组：34.7°，非肌肉减少症组：24.3°，p < 0.01），肌肉减少症组和非肌肉减少症组之间的脊柱骨盆参数无显著差异。脊柱骨盆失配患者的患病率在肌肉减少症组和非肌肉减少症组之间也无显著差异（37.0%对42.4%，p = 0.66）。在没有脊柱骨盆失配的患者中，两组之间没有脊柱骨盆参数有显著差异。然而，在有脊柱骨盆失配的患者中，肌肉减少症组的矢状位脊柱轴（SVA）（115.7 mm对58.7 mm，p < 0.01）和TK（36.6°对21.3°，p < 0.01）显著大于非肌肉减少症组。此外，在调整年龄后，肌肉减少症与脊柱骨盆失配患者的SVA（β = 50.7，p < 0.01）和TK（β = 14.0，p < 0.01）显著增加独立相关。
由于脊柱骨盆失配患者胸椎后凸变平补偿不足，肌肉减少症与脊柱矢状面失衡有关。这些幻灯片可在电子补充材料中获取。
