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Sarcopenia is related to spinal sagittal imbalance in patients with spinopelvic mismatch

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Abstract

Purpose

To clarify the relationship between sarcopenia and spinopelvic parameters.

Methods

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.

Results

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.

Conclusions

Sarcopenia is related to spinal sagittal imbalance because of insufficient compensation by flattening thoracic kyphosis in patients with spinopelvic mismatch.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan

    Shoichiro Ohyama, Masatoshi Hoshino, Hidetomi Terai, Hiromitsu Toyoda, Akinobu Suzuki, Shinji Takahashi, Kazunori Hayashi, Koji Tamai, Yusuke Hori & Hiroaki Nakamura

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  1. Shoichiro Ohyama
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  2. Masatoshi Hoshino
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  3. Hidetomi Terai
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Correspondence to Shoichiro Ohyama.

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The study protocol was approved by the Institutional Review Board of our institution (No. 3170).

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Ohyama, S., Hoshino, M., Terai, H. et al. Sarcopenia is related to spinal sagittal imbalance in patients with spinopelvic mismatch. Eur Spine J 28, 1929–1936 (2019). https://doi.org/10.1007/s00586-019-06066-2

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  • DOI: https://doi.org/10.1007/s00586-019-06066-2

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