European Spine Journal

, Volume 27, Issue 10, pp 2650–2659 | Cite as

The effect of muscle ageing and sarcopenia on spinal segmental loads

  • Dominika Ignasiak
  • Waldo Valenzuela
  • Mauricio Reyes
  • Stephen J. Ferguson
Original Article



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.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Sarcopenia 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.

Supplementary material

586_2018_5729_MOESM1_ESM.pptx (181 kb)
Supplementary material 1 (PPTX 181 kb)
586_2018_5729_MOESM2_ESM.docx (698 kb)
Supplementary material 2 (DOCX 697 kb)


  1. 1.
    Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22(3):465–475. CrossRefGoogle Scholar
  2. 2.
    Ross PD (1997) Clinical consequences of vertebral fractures. Am J Med 103(2):S30–S43. CrossRefGoogle Scholar
  3. 3.
    Melton LJ III, Atkinson EJ, Cooper C, O’Fallon WM, Riggs BL (1999) Vertebral fractures predict subsequent fractures. Osteoporos Int 10(3):214–221. CrossRefGoogle Scholar
  4. 4.
    Briggs AM, Greig AM, Wark JD (2007) The vertebral fracture cascade in osteoporosis: a review of aetiopathogenesis. Osteoporos Int 18(5):575–584. CrossRefGoogle Scholar
  5. 5.
    World Population Ageing (2015). United Nations. Department of Economic and Social Affairs / Population Division: New YorkGoogle Scholar
  6. 6.
    Mokhtarzadeh H, Anderson DE (2016) The role of trunk musculature in osteoporotic vertebral fractures: implications for prediction, prevention, and management. Curr Osteoporos Rep 14(3):67–76. CrossRefGoogle Scholar
  7. 7.
    Doherty TJ (2003) Invited review: aging and sarcopenia. J Appl Physiol 95(4):1717–1727. CrossRefGoogle Scholar
  8. 8.
    von Haehling S, Morley JE, Anker SD (2010) An overview of sarcopenia: facts and numbers on prevalence and clinical impact. J Cachexia, Sarcopenia Muscle 1(2):129–133. CrossRefGoogle Scholar
  9. 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. CrossRefGoogle Scholar
  10. 10.
    Tagliaferri C, Wittrant Y, Davicco MJ, Walrand S, Coxam V (2015) Muscle and bone, two interconnected tissues. Ageing Res Rev 21:55–70. CrossRefGoogle Scholar
  11. 11.
    Edwards MH, Dennison EM, Aihie Sayer A, Fielding R, Cooper C (2015) Osteoporosis and sarcopenia in older age. Bone 80:126–130. CrossRefPubMedCentralPubMedGoogle Scholar
  12. 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. CrossRefGoogle Scholar
  13. 13.
    Wu CH, Yang KC, Chang HH, Yen JF, Tsai KS, Huang KC (2013) Sarcopenia is related to increased risk for low bone mineral density. J Clin Densitom 16(1):98–103. CrossRefGoogle Scholar
  14. 14.
    Singer K, Edmondston S, Day R, Breidahl P, Price R (1995) Prediction of thoracic and lumbar vertebral body compressive strength: correlations with bone mineral density and vertebral region. Bone 17(2):167–174. CrossRefGoogle Scholar
  15. 15.
    Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone 30(6):836–841CrossRefGoogle Scholar
  16. 16.
    Dahlqvist J, Vissing C, Hedermann G, Thomsen C, Vissing J (2015) Paraspinal fat infiltration in healthy adults with aging. Neuromuscul Disord 25:S273. CrossRefGoogle Scholar
  17. 17.
    Crawford RJ, Filli L, Elliott JM, Nanz D, Fischer MA, Marcon M, Ulbrich EJ (2016) Age- and level-dependence of fatty infiltration in lumbar paravertebral muscles of healthy volunteers. AJNR Am J Neuroradiol 37(4):742–748. CrossRefGoogle Scholar
  18. 18.
    Lee SH, Park SW, Kim YB, Nam TK, Lee YS (2016) The fatty degeneration of lumbar paraspinal muscles on computed tomography scan according to age and disc level. Spine J. CrossRefGoogle Scholar
  19. 19.
    Singh DK, Bailey M, Lee RY (2011) Ageing modifies the fibre angle and biomechanical function of the lumbar extensor muscles. Clin Biomech (Bristol, Avon) 26(6):543–547. CrossRefGoogle Scholar
  20. 20.
    Quirk DA, Hubley-Kozey CL (2014) Age-related changes in trunk neuromuscular activation patterns during a controlled functional transfer task include amplitude and temporal synergies. Hum Mov Sci 38:262–280. CrossRefGoogle Scholar
  21. 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. CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E, Bernabei R, Onder G (2012) Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr 31(5):652–658. CrossRefPubMedGoogle Scholar
  23. 23.
    Jamshidnejad S, Arjmand N (2015) Variations in trunk muscle activities and spinal loads following posterior lumbar surgery: a combined in vivo and modeling investigation. Clin Biomech (Bristol, Avon) 30(10):1036–1042. CrossRefGoogle Scholar
  24. 24.
    Malakoutian M, Street J, Wilke H-J, Stavness I, Dvorak M, Fels S, Oxland T (2016) Role of muscle damage on loading at the level adjacent to a lumbar spine fusion: a biomechanical analysis. Eur Spine J 25(9):2929–2937. CrossRefGoogle Scholar
  25. 25.
    Briggs AM, van Dieen JH, Wrigley TV, Greig AM, Phillips B, Lo SK, Bennell KL (2007) Thoracic kyphosis affects spinal loads and trunk muscle force. Phys Ther 87(5):595–607. CrossRefGoogle Scholar
  26. 26.
    Briggs AM, Wrigley TV, van Dieen JH, Phillips B, Lo SK, Greig AM, Bennell KL (2006) The effect of osteoporotic vertebral fracture on predicted spinal loads in vivo. Eur Spine J 15(12):1785–1795. CrossRefGoogle Scholar
  27. 27.
    Rasmussen J, Tørholm S, de Zee M (2009) Computational analysis of the influence of seat pan inclination and friction on muscle activity and spinal joint forces. Int J Ind Ergon 39(1):52–57. CrossRefGoogle Scholar
  28. 28.
    Han KS, Rohlmann A, Zander T, Taylor WR (2013) Lumbar spinal loads vary with body height and weight. Med Eng Phys 35(7):969–977. CrossRefGoogle Scholar
  29. 29.
    Ignasiak D, Dendorfer S, Ferguson SJ (2016) Thoracolumbar spine model with articulated ribcage for the prediction of dynamic spinal loading. J Biomech 49(6):959–966. CrossRefGoogle Scholar
  30. 30.
    Ignasiak D, Ferguson SJ, Arjmand N (2016) A rigid thorax assumption affects model loading predictions at the upper but not lower lumbar levels. J Biomech 49(13):3074–3078. CrossRefGoogle Scholar
  31. 31.
    Pearcy MJ, Bogduk N (1988) Instantaneous axes of rotation of the lumbar intervertebral joints. Spine 13(9):1033–1041CrossRefGoogle Scholar
  32. 32.
    Essendrop M (2003) Significance of intra-abdominal pressure in work related trunk loading. National Institute of Occupational Health, DenmarkGoogle Scholar
  33. 33.
    Han KS, Zander T, Taylor WR, Rohlmann A (2012) An enhanced and validated generic thoraco-lumbar spine model for prediction of muscle forces. Med Eng Phys 34(6):709–716. CrossRefGoogle Scholar
  34. 34.
    Arshad R, Zander T, Dreischarf M, Schmidt H (2016) Influence of lumbar spine rhythms and intra-abdominal pressure on spinal loads and trunk muscle forces during upper body inclination. Med Eng Phys 38(4):333–338. CrossRefGoogle Scholar
  35. 35.
    de Zee M, Hansen L, Wong C, Rasmussen J, Simonsen EB (2007) A generic detailed rigid-body lumbar spine model. J Biomech 40(6):1219–1227. CrossRefGoogle Scholar
  36. 36.
    de Zee M, Falla D, Farina D, Rasmussen J (2007) A detailed rigid-body cervical spine model based on inverse dynamics. J Biomech 40:S284. CrossRefGoogle Scholar
  37. 37.
    Christophy M, Faruk Senan NA, Lotz JC, O’Reilly OM (2012) A musculoskeletal model for the lumbar spine. Biomech Model Mechanobiol 11(1–2):19–34. CrossRefGoogle Scholar
  38. 38.
    Bruno AG, Bouxsein ML, Anderson DE (2015) Development and validation of a musculoskeletal model of the fully articulated thoracolumbar spine and rib cage. J Biomech Eng 137(8):081003. CrossRefGoogle Scholar
  39. 39.
    Kang CH, Shin MJ, Kim SM, Lee SH, Lee CS (2007) MRI of paraspinal muscles in lumbar degenerative kyphosis patients and control patients with chronic low back pain. Clin Radiol 62(5):479–486. CrossRefGoogle Scholar
  40. 40.
    Kjaer P, Bendix T, Sorensen JS, Korsholm L, Leboeuf-Yde C (2007) Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain? BMC Med 5:2. CrossRefPubMedCentralPubMedGoogle Scholar
  41. 41.
    Lang T, Streeper T, Cawthon P, Baldwin K, Taaffe DR, Harris TB (2010) Sarcopenia: etiology, clinical consequences, intervention, and assessment. Osteoporos Int 21(4):543–559. CrossRefGoogle Scholar
  42. 42.
    Damsgaard M, Rasmussen J, Christensen ST, Surma E, de Zee M (2006) Analysis of musculoskeletal systems in the anybody modeling system. Simul Model Pract Theory 14(8):1100–1111. CrossRefGoogle Scholar
  43. 43.
    Ignasiak D, Rueger A, Ferguson SJ (2017) Multi-segmental thoracic spine kinematics measured dynamically in the young and elderly during flexion. Hum Mov Sci 54:230–239. CrossRefGoogle Scholar
  44. 44.
    Erdemir A, McLean S, Herzog W, van den Bogert AJ (2007) Model-based estimation of muscle forces exerted during movements (Bristol, Avon). Clin Biomech 22(2):131–154. CrossRefGoogle Scholar
  45. 45.
    Rasmussen J, Damsgaard M, Voigt M (2001) Muscle recruitment by the min/max criterion—a comparative numerical study. J Biomech 34(3):409–415CrossRefGoogle Scholar
  46. 46.
    Stokes IA, Gardner-Morse M (1995) Lumbar spine maximum efforts and muscle recruitment patterns predicted by a model with multijoint muscles and joints with stiffness. J Biomech 28(2):173–186CrossRefGoogle Scholar
  47. 47.
    McGill SM, Yingling VR, Peach JP (1999) Three-dimensional kinematics and trunk muscle myoelectric activity in the elderly spine—a database compared to young people. Clin Biomech (Bristol, Avon) 14(6):389–395CrossRefGoogle Scholar
  48. 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. CrossRefPubMedCentralPubMedGoogle Scholar
  49. 49.
    Aquarius R, Homminga J, Verdonschot N, Tanck E (2011) The fracture risk of adjacent vertebrae is increased by the changed loading direction after a wedge fracture. Spine 36(6):408–412. CrossRefGoogle Scholar
  50. 50.
    Narici MV, Maffulli N, Maganaris CN (2008) Ageing of human muscles and tendons. Disabil Rehabil 30(20–22):1548–1554. CrossRefGoogle Scholar
  51. 51.
    Arjmand N, Shirazi-Adl A (2006) Role of intra-abdominal pressure in the unloading and stabilization of the human spine during static lifting tasks. Eur Spine J 15(8):1265–1275. CrossRefGoogle Scholar
  52. 52.
    Cholewicki J, Juluru K, McGill SM (1999) Intra-abdominal pressure mechanism for stabilizing the lumbar spine. J Biomech 32(1):13–17CrossRefGoogle Scholar
  53. 53.
    Stokes IA, Gardner-Morse MG, Henry SM (2010) Intra-abdominal pressure and abdominal wall muscular function: spinal unloading mechanism. Clin Biomech (Bristol, Avon) 25(9):859–866. CrossRefGoogle Scholar
  54. 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. CrossRefGoogle Scholar
  55. 55.
    Anderson DE, D’Agostino JM, Bruno AG, Manoharan RK, Bouxsein ML (2012) Regressions for estimating muscle parameters in the thoracic and lumbar trunk for use in musculoskeletal modeling. J Biomech 45(1):66–75. CrossRefGoogle Scholar
  56. 56.
    Valenzuela W, Ferguson SJ, Ignasiak D, Diserens G, Hani L, Wiest R, Vermathen P, Boesch C, Reyes M (2016) FISICO: fast image segmentation correction. PLoS ONE 11(5):1–17. CrossRefGoogle Scholar
  57. 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
  58. 58.
    Maughan RJ, Watson JS, Weir J (1983) Strength and cross-sectional area of human skeletal muscle. J Physiol 338:37–49CrossRefPubMedGoogle Scholar
  59. 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. CrossRefPubMedCentralPubMedGoogle Scholar
  60. 60.
    Bruno AG, Anderson DE, D’Agostino J, Bouxsein ML (2012) The effect of thoracic kyphosis and sagittal plane alignment on vertebral compressive loading. J Bone Miner Res 27(10):2144–2151. CrossRefPubMedCentralPubMedGoogle Scholar
  61. 61.
    Ignasiak D, Rueger A, Sperr R, Ferguson SJ (2017) Thoracolumbar spine loading associated with kinematics of the young and the elderly during activities of daily living. J Biomech 70:175–184. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute for Biomechanics, ETH ZurichZurichSwitzerland
  2. 2.Institute for Surgical Technology and Biomechanics, University of BernBernSwitzerland

Personalised recommendations