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Scoliosis Research Society-22r score is affected by standing whole body sagittal alignment, age, and sex, but not by standing balance or skeletal muscle mass in healthy volunteers

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Abstract

Purpose

Aging and spinal disease impair standing whole body sagittal alignment (WBS alignment), which leads to stooping. When WBS alignment deteriorates, compensatory mechanisms are activated to maintain standing posture. Increase of the compensation impairs health-related quality of life (HRQOL). The purpose of this research was to determine whether postural factors, age, and sex affect HRQOL.

Methods

This cross-sectional study evaluated the influence of WBS alignment, standing body sway (balance), skeletal muscle mass (SMM), aging, and sex on HRQOL in healthy volunteers (n = 150; mean age 40.9 years [20–76], 96 women). Age, sex, weight, height, and body mass index (BMI) were obtained. HRQOL was assessed with Scoliosis Research Society-22 (SRS-22r). WBS alignment and balance were measured by EOS imaging with simultaneous force plate measurement. SMM was measured using a medical body composition analyzer. Based on the bivariate analysis between the SRS-22r subtotal and all parameters, selected ten parameters were used for multivariate logistic regression analysis to identify affecting factors to SRS-22r.

Results

Men had significantly higher weight, height, BMI, and SRS-22r score in all domains. The L4-S1 lumbar lordosis angle was greater in men, and pelvic tilt and knee hyperextension were greater in women. Women had a more stable standing posture, whereas men had significantly higher SMM values. Multivariate logistic regression analysis revealed that age, sex, and TPA were identified as significant factors affecting SRS-22r.

Conclusions

In healthy volunteers, SRS-22r is affected by aging, sex (woman had a lower score), and sagittal malalignment. Neither Standing balance nor SMM, however, affect SRS-22r.4

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Acknowledgements

The authors deeply thank Masashi Okamoto, MS, Dept. of Radiological Technology, School of Health Science, Faculty of Medicine, Niigata University, for his contribution to the data collection and adjustment, and Satoshi Aoki, Representative Director, seca Nihon, for his advice on bioelectrical impedance analysis of skeletal muscle mass.

Funding

No funding has received for the present study and the scientific paper.

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Authors and Affiliations

  1. Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata City, 950-0165, Japan

    Kazuhiro Hasegawa & Shun Hatsushikano

  2. Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan

    Kei Watanabe & Masayuki Ohashi

  3. Académie Nationale de Médecine, 16 Rue Bonaparte, 75006, Paris, France

    Jean Dubousset

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  1. Kazuhiro Hasegawa
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Contributions

K. H contributed to study design, data collection, manuscript writing, and statistical analysis, S. H contributed to data collection and radiologic measurement, K. W contributed to manuscript editing, M. O contributed to manuscript editing, J. D contributed to conceptual advice for study design and manuscript editing.

Corresponding author

Correspondence to Kazuhiro Hasegawa.

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Conflict of interest

None of the authors received financial support or COI for the present study.

Ethics approval

The ethics committee of Medical Corporation Aijinkai approved the study with the committee’s reference number: IRB Approval #6 [R1] – 2019, on May 16, 2019.

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A written informed consent to participate in the present study was obtained from all the participants.

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Hasegawa, K., Hatsushikano, S., Watanabe, K. et al. Scoliosis Research Society-22r score is affected by standing whole body sagittal alignment, age, and sex, but not by standing balance or skeletal muscle mass in healthy volunteers. Eur Spine J 31, 3000–3012 (2022). https://doi.org/10.1007/s00586-022-07360-2

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