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Impact of pelvic incidence on lumbar osteophyte formation and disc degeneration in middle-aged and elderly people in a prospective cross-sectional cohort

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Abstract

Purpose

Pelvic incidence (PI) is unique to each individual and does not change throughout life. High PI is related to lumbar spondylolisthesis, but associations of PI with lumbar osteophyte formation and disc degeneration are unclear. The objective was to evaluate relationships of PI with lumbar osteophyte formation and disc degeneration, as well as spinal sagittal alignment and geriatric diseases, in middle-aged and elderly people.

Methods

A total of 1002 volunteers (male: 434, female: 568, average age: 63.5) were prospectively examined for lumbar osteophyte formation (Nathan class ≥ 2) and disc degeneration (disc score ≥ 3). High (PI > 51, n = 501) and low (PI ≤ 51, n = 501) PI groups were defined. Clinical factors, frailty, sarcopenia, and physical quality of life (QOL) were compared between these groups, and risk factors for lumbar osteophyte formation and disc degeneration were identified in multivariate logistic regression analysis.

Results

Physical QOL was poorer in people with lumbar osteophyte formation (54.8%) and disc degeneration (33.6%). Age, male gender, spinal parameters including PI, bone mineral density, back muscle strength, and gait ability differed significantly between the groups, whereas frailty and sarcopenia were not significantly different. Low PI, low lumbar lordosis, elder age, male gender, high BMI, and weak back muscle strength were significant risk factors for lumbar osteophyte formation and disc degeneration.

Conclusions

Low PI was identified as a risk factor for lumbar osteophyte formation and disc degeneration, both of which reduce physical QOL in middle-aged and elderly people.

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Acknowledgements

We are grateful to the staff of the Comprehensive Health Care Programme held in Yakumo, Hokkaido; to Mr. Masato Kako and Ms. Azusa Kayamoto in the Department of Rehabilitation, Nagoya University Hospital; to Ms. Aya Hemmi and Ms. Hiroko Ino at Nagoya University; and to all the staff of the central clerk desk in Nagoya University Hospital for their assistance throughout this study.

Funding

This study was supported by Japanese Ministry of Health, Labour, and Welfare Grants-in-Aid for Scientific Research (C) (18K09102). No other funds were received in support of this work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan

    Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Masaaki Machino, Satoshi Tanaka, Masayoshi Morozumi, Shunsuke Kanbara, Sadayuki Ito, Taro Inoue, Taisuke Seki, Shinya Ishizuka, Hiroaki Nakashima & Naoki Ishiguro

  2. Department of Rehabilitation, Kansai University of Welfare Sciences, 3-11-1, Asahigaoka, Kashiwara, Osaka, 582-0026, Japan

    Yukiharu Hasegawa

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Imagama, S., Ando, K., Kobayashi, K. et al. Impact of pelvic incidence on lumbar osteophyte formation and disc degeneration in middle-aged and elderly people in a prospective cross-sectional cohort. Eur Spine J 29, 2262–2271 (2020). https://doi.org/10.1007/s00586-019-06204-w

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