The effect of muscle ageing and sarcopenia on spinal segmental loads
The interrelations between age-related muscle deterioration (sarcopenia) and vertebral fractures have been suggested based on clinical observations, but the biomechanical relationships have not been explored. The study aim was to investigate the effects of muscle ageing and sarcopenia on muscle recruitment patterns and spinal loads, using musculoskeletal multi-body modelling.
A generic AnyBody model of the thoracolumbar spine, including > 600 fascicles representing trunk musculature, was used. Several stages of normal ageing and sarcopenia were modelled by reduced strength of erector spinae and multifidus muscles (ageing from 3rd to 6th life decade: ≥ 60% of normal strength; sarcopenia: mild 60%, moderate 48%, severe 36%, very severe 24%), reflecting the reported decrease in cross-sectional area and increased fat infiltration. All other model parameters were kept unchanged. Full-range flexion was simulated using inverse dynamics with muscle optimization to predict spinal loads and muscle recruitment patterns.
The muscle changes due to normal ageing (≥ 60% strength) had a minor effect on predicted loads and provoked only slightly elevated muscle activities. Severe (36%) and very severe (24%) stages of sarcopenia, however, were associated with substantial increases in compression (by up to 36% or 318N) at the levels of the upper thoracic spine (T1T2–T5T6) and shear loading (by up to 75% or 176N) along the whole spine (T1T2–L4L5). The muscle activities increased for almost all muscles, up to 100% of their available strength.
The study highlights the distinct and detrimental consequences of sarcopenia, in contrast to normal ageing, on spinal loading and required muscular effort.
KeywordsSarcopenia Trunk muscles Spinal loads Biomechanical model
This study was funded by a research grant from AOSpine International, Switzerland (Project CPP FFOB_OC_14).
Compliance with ethical standards
Conflict of interest
Dominika Ignasiak, Waldo Valenzuela, Mauricio Reyes, and Stephen J. Ferguson declare that they have no conflict of interest.
- 5.World Population Ageing (2015). United Nations. Department of Economic and Social Affairs / Population Division: New YorkGoogle Scholar
- 9.Hida T, Shimokata H, Sakai Y, Ito S, Matsui Y, Takemura M, Kasai T, Ishiguro N, Harada A (2016) Sarcopenia and sarcopenic leg as potential risk factors for acute osteoporotic vertebral fracture among older women. Eur Spine J 25(11):3424–3431. https://doi.org/10.1007/s00586-015-3805-5 CrossRefGoogle Scholar
- 12.Verschueren S, Gielen E, O’Neill TW, Pye SR, Adams JE, Ward KA, Wu FC, Szulc P, Laurent M, Claessens F, Vanderschueren D, Boonen S (2013) Sarcopenia and its relationship with bone mineral density in middle-aged and elderly European men. Osteoporos Int 24(1):87–98. https://doi.org/10.1007/s00198-012-2057-z CrossRefGoogle Scholar
- 21.Helbostad JL, Sturnieks DL, Menant J, Delbaere K, Lord SR, Pijnappels M (2010) Consequences of lower extremity and trunk muscle fatigue on balance and functional tasks in older people: a systematic literature review. BMC Geriatr 10:56. https://doi.org/10.1186/1471-2318-10-56 CrossRefPubMedCentralPubMedGoogle Scholar
- 32.Essendrop M (2003) Significance of intra-abdominal pressure in work related trunk loading. National Institute of Occupational Health, DenmarkGoogle Scholar
- 48.Greig AM, Briggs AM, Bennell KL, Hodges PW (2014) Trunk muscle activity is modified in osteoporotic vertebral fracture and thoracic kyphosis with potential consequences for vertebral health. PLoS ONE 9(10):e109515. https://doi.org/10.1371/journal.pone.0109515 CrossRefPubMedCentralPubMedGoogle Scholar
- 54.Cuellar WA, Wilson A, Blizzard CL, Otahal P, Callisaya ML, Jones G, Hides JA, Winzenberg TM (2016) The assessment of abdominal and multifidus muscles and their role in physical function in older adults: a systematic review. Physiotherapy. https://doi.org/10.1016/j.physio.2016.06.001 CrossRefGoogle Scholar
- 57.Valenzuela W, Vermathen P, Boesch C, Nolte LP, Reyes M (2013) iSix - Image Segmentation in Osirix. In: Paper presented at the 30th Annual Scientific Meeting of the European Society for Magnetic Resonance in Medicine and Biology: Toulouse, October 3–5Google Scholar
- 59.McGregor RA, Cameron-Smith D, Poppitt SD (2014) It is not just muscle mass: a review of muscle quality, composition and metabolism during ageing as determinants of muscle function and mobility in later life. Longev Healthspan 3:9. https://doi.org/10.1186/2046-2395-3-9 CrossRefPubMedCentralPubMedGoogle Scholar