Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
Department of Rehabilitation, Kansai University of Welfare Sciences, 3-11-1, Asahigaoka, Kashiwara, Osaka, 582-0026, Japan.
Eur Spine J. 2020 Sep;29(9):2262-2271. doi: 10.1007/s00586-019-06204-w. Epub 2020 Mar 4.
Pelvic incidence (PI) is unique to each individual and does not change throughout life. High PI is related to lumbar spondylolisthesis, but associations of PI with lumbar osteophyte formation and disc degeneration are unclear. The objective was to evaluate relationships of PI with lumbar osteophyte formation and disc degeneration, as well as spinal sagittal alignment and geriatric diseases, in middle-aged and elderly people.
A total of 1002 volunteers (male: 434, female: 568, average age: 63.5) were prospectively examined for lumbar osteophyte formation (Nathan class ≥ 2) and disc degeneration (disc score ≥ 3). High (PI > 51, n = 501) and low (PI ≤ 51, n = 501) PI groups were defined. Clinical factors, frailty, sarcopenia, and physical quality of life (QOL) were compared between these groups, and risk factors for lumbar osteophyte formation and disc degeneration were identified in multivariate logistic regression analysis.
Physical QOL was poorer in people with lumbar osteophyte formation (54.8%) and disc degeneration (33.6%). Age, male gender, spinal parameters including PI, bone mineral density, back muscle strength, and gait ability differed significantly between the groups, whereas frailty and sarcopenia were not significantly different. Low PI, low lumbar lordosis, elder age, male gender, high BMI, and weak back muscle strength were significant risk factors for lumbar osteophyte formation and disc degeneration.
Low PI was identified as a risk factor for lumbar osteophyte formation and disc degeneration, both of which reduce physical QOL in middle-aged and elderly people. These slides can be retrieved under Electronic Supplementary Material.
骨盆入射角（PI）因人而异，且终生不变。PI 增大与腰椎滑脱有关，但 PI 与腰椎骨赘形成和椎间盘退变的关系尚不清楚。本研究旨在评估 PI 与腰椎骨赘形成和椎间盘退变的关系，以及与中老年人群脊柱矢状位平衡和老年疾病的关系。
前瞻性纳入 1002 名志愿者（男性 434 名，女性 568 名，平均年龄 63.5 岁），评估其腰椎骨赘形成（Nathan 分级≥2）和椎间盘退变（椎间盘评分≥3）情况。将 PI 较高（PI＞51，n＝501）和较低（PI≤51，n＝501）的人群分别定义为高 PI 组和低 PI 组。比较两组的临床特征、虚弱、肌肉减少症和身体质量（QOL），并采用多变量逻辑回归分析确定腰椎骨赘形成和椎间盘退变的危险因素。
有腰椎骨赘形成（54.8%）和椎间盘退变（33.6%）的患者身体 QOL 更差。年龄、性别、包括 PI 在内的脊柱参数、骨密度、腰背肌肉力量和步态能力在两组间差异有统计学意义，而虚弱和肌肉减少症在两组间无明显差异。低 PI、低腰椎前凸、年龄较大、男性、高 BMI 和腰背肌肉力量较弱是腰椎骨赘形成和椎间盘退变的显著危险因素。
低 PI 是腰椎骨赘形成和椎间盘退变的危险因素，这两种疾病均会降低中老年人群的身体 QOL。这些幻灯片可以在电子补充材料中检索到。
