腰椎管狭窄症患者肌少症的临床特征。
Clinical Features of Sarcopenia in Patients With Lumbar Spinal Stenosis.
机构信息
Spine Care Center, Wakayama Medical University Kihoku Hospital, Japan.
出版信息
Spine (Phila Pa 1976). 2020 Sep 1;45(17):E1105-E1110. doi: 10.1097/BRS.0000000000003498.
STUDY DESIGN
Cross-sectional design.
OBJECTIVE
To investigate the prevalence of sarcopenia and identify factors associated with sarcopenia in patients with lumbar spinal stenosis (LSS).
SUMMARY OF BACKGROUND DATA
Patients with LSS have a higher prevalence of sarcopenia compared with healthy older adults. However, the clinical features of sarcopenia in patients with LSS are poorly understood and the factors affecting sarcopenia in patients with LSS remain unclear.
METHODS
Patients diagnosed with LSS based on clinical examination and magnetic resonance imaging findings, and referred to physical therapy, were enrolled. Muscle mass was measured using bioelectrical impedance using InBody S10. We collected a numerical rating scale (NRS) for back pain, the 36-Item Short-Form Survey (SF-36), the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), bone mineral density (BMD), and radiographic measurements of spinal alignment. Sarcopenia was defined according to the Asian Working Group for Sarcopenia guidelines and patients were classified into sarcopenia or nonsarcopenia groups.
RESULTS
A total of 178 patients were enrolled: 35 in the sarcopenia group and 143 in the nonsarcopenia group. The prevalence of sarcopenia was 19.7%. The average percent of slip (% slip) among patients in the sarcopenia group was significantly higher compared with those in the nonsarcopenia group (P < 0.05). Body mass index (BMI), BMD, physical function as assessed by the SF-36, and gait disturbance as assessed by the JOABPEQ were significantly lower in the sarcopenia group compared with those in the nonsarcopenia group (P < 0.05). A trend was observed toward between-group differences in back pain on the NRS (P < 0.1). In the logistic regression analysis, significant associations were seen between sarcopenia and % slip (odds ratio 1.15, 95% CI 1.01-1.30).
CONCLUSION
Patients with LSS and sarcopenia have a higher degree of slippage and lower BMI, BMD, and physical function, and reported more severe low back pain, compared with those without sarcopenia.
LEVEL OF EVIDENCE
研究设计
横断面设计。
目的
调查腰椎管狭窄症（LSS）患者中肌少症的患病率，并确定与肌少症相关的因素。
背景数据概要
与健康老年人相比，LSS 患者肌少症的患病率更高。然而，LSS 患者肌少症的临床特征尚不清楚，影响 LSS 患者肌少症的因素仍不清楚。
方法
根据临床检查和磁共振成像结果诊断为 LSS 并转至物理治疗的患者被纳入研究。使用 InBody S10 进行生物电阻抗测量肌肉质量。我们收集了数字评分量表（NRS）用于背痛、36 项简短健康调查（SF-36）、日本矫形协会腰痛评估问卷（JOABPEQ）、骨密度（BMD）和脊柱排列的放射学测量。根据亚洲肌少症工作组的指南定义肌少症，将患者分为肌少症或非肌少症组。
结果
共纳入 178 例患者：肌少症组 35 例，非肌少症组 143 例。肌少症的患病率为 19.7%。肌少症组患者的平均滑脱百分比（% slip）明显高于非肌少症组（P<0.05）。肌少症组的体重指数（BMI）、BMD、SF-36 评估的身体功能和 JOABPEQ 评估的步态障碍明显低于非肌少症组（P<0.05）。NRS 评估的背痛在两组之间存在差异的趋势（P<0.1）。在逻辑回归分析中，肌少症与% slip 之间存在显著关联（比值比 1.15，95%CI 1.01-1.30）。
结论
与非肌少症患者相比，LSS 合并肌少症患者的滑脱程度更高，BMI、BMD 和身体功能更低，报告的腰痛更严重。
证据水平
4 级。
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