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Relationship between body mass index and spinal pathology in community-dwelling older adults

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Abstract

Purpose

To clarify the relationship between body mass index (BMI) and spinal pathologies including spinal sagittal balance, back extensor strength (BES), paraspinal muscle mass, prevalent vertebral fracture, disc degeneration, Modic changes, low back pain, and quality of life (QOL) in community-dwelling older adults.

Methods

This study included 380 participants (age: ≥ 65 years, male/female: 152/228) from the Shiraniwa Study. Multivariate nonlinear regression analysis was used to investigate the relationship between BMI and sagittal vertical axis (SVA), BES, paraspinal muscle mass, visual analog scale (VAS) for low back pain, Oswestry Disability Index (ODI), and EuroQoL-5 Dimension (EQ5D) score after adjusting for sex, age, Hospital Anxiety and Depression Scale score, and Charlson Comorbidity Index. In addition, multiple logistic regression analysis was used to investigate the association between BMI and prevalent vertebral fracture, disc degeneration, and Modic changes.

Results

BMI was significantly correlated with SVA, BES, paraspinal muscle mass, VAS, ODI, and EQ5D score. The increase in BMI was associated with the deterioration of all outcomes, which accelerated when the BMI increased from approximately 22–23 kg/m2. Moreover, overweight/obesity was significantly correlated with disc degeneration and Modic changes.

Conclusion

Increased BMI is significantly associated with spinal pathologies such as SVA, BES, paraspinal muscle mass, VAS, QOL, disc degeneration, and Modic changes. The findings suggest that measures for controlling overweight and obesity among older adults can play an important role in the prevention and treatment of spinal pathologies.

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Acknowledgements

The authors thank Satomi Kawabata for assisting with data collection and conducting interviews with participants. The authors also express sincere thanks to the staff of Shiraniwa Hospital for their help in conducting the Shiraniwa Study.

Funding

This study was financially supported by a Japanese Orthopaedic Association Research Grant (2017–1).

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Shiraniwa Hospital, 6-10-1, Ikoma, Nara, Japan

    Yuichi Takeuchi

  2. Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan

    Shinji Takahashi, Akito Yabu, Hidetomi Terai & Hiroaki Nakamura

  3. Department of Orthopedic Surgery, Nishinomiya Watanabe Hospital, Hyogo, Japan

    Shoichiro Ohyama

  4. Department of Orthopedic Surgery, PL Hospital, Osaka, Japan

    Yusuke Hori

  5. Department of Orthopedic Surgery, Shiraniwa Hospital, Nara, Japan

    Tadao Tsujio & Akio Kobayashi

  6. Kotake Orthopedic Clinic, Nara, Japan

    Shiro Kotake

  7. Department of Orthopedic Surgery, Osaka City General Hospital, Osaka, Japan

    Masatoshi Hoshino

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  1. Yuichi Takeuchi
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  2. Shinji Takahashi
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  3. Shoichiro Ohyama
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Corresponding author

Correspondence to Yuichi Takeuchi.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study protocol was approved by the Osaka City University Ethics Committee (approval no. 3484). All participants provided written informed consent.

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Takeuchi, Y., Takahashi, S., Ohyama, S. et al. Relationship between body mass index and spinal pathology in community-dwelling older adults. Eur Spine J 32, 428–435 (2023). https://doi.org/10.1007/s00586-022-07495-2

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  • DOI: https://doi.org/10.1007/s00586-022-07495-2

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