Relationship Between Muscle Mass of the Lower Limbs and Falls Caused by Spinal Misalignment in Women Aged 70 Years: A Retrospective Study.
Journal
Clinical spine surgery
ISSN: 2380-0194
Titre abrégé: Clin Spine Surg
Pays: United States
ID NLM: 101675083
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
received:
25
07
2019
accepted:
24
04
2020
pubmed:
27
5
2020
medline:
26
10
2021
entrez:
27
5
2020
Statut:
ppublish
Résumé
This retrospective study was conducted from 2015 to 2016 at the osteoporosis outpatient clinic of Showa University School of Medicine. This study aimed to investigate the association between lower-limb muscle mass and spinal misalignment-related falls in elderly women. Poor spinal alignment affects gait and balance, reducing the quality of life. Negative correlations between age-associated skeletal muscle loss and spinal sagittal alignment have been reported. This study included 127 women with osteoporosis aged more than 70 years. The correlation between lower-limb skeletal muscle index (SMI) and sagittal vertical axis (SVA) was calculated using radiographic measurements. Spinopelvic parameters, including SVA, sacral slope, pelvic tilt (PT), pelvic incidence, and lumbar lordosis, were measured. Lower-limb SMI was measured using whole-body dual-energy x-ray absorptiometry and calculated as SMI=nonfat mass/height2. The balance function was evaluated using the single-leg stance test. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests; significance level was set at P<0.05. Bivariate and multivariate logistic regression analyses were used to determine correlations. Participants were classified into the balance and mismatch groups on the basis of a threshold SVA value of 50 mm. The groups did not differ significantly in age, height, weight, pelvic incidence, or sacral slope. Lumbar lordosis significantly decreased and PT and lower-limb SMI significantly increased in the mismatch group compared with the balance group. Lower-limb SMI was significantly correlated with increased SVA in bivariate and multivariate regression analyses. Patients with PT ≥20 degrees and SVA ≥50 mm had significantly increased lower-limb SMI. Increased SVA is associated with increased lower-limb SMI, which negatively affects standing balance. An increased lower-limb SMI may represent a novel compensatory mechanism for poor spinal alignment in elderly women with osteoporosis. Level III.
Sections du résumé
STUDY DESIGN
This retrospective study was conducted from 2015 to 2016 at the osteoporosis outpatient clinic of Showa University School of Medicine.
OBJECTIVE
This study aimed to investigate the association between lower-limb muscle mass and spinal misalignment-related falls in elderly women.
SUMMARY OF BACKGROUND DATA
Poor spinal alignment affects gait and balance, reducing the quality of life. Negative correlations between age-associated skeletal muscle loss and spinal sagittal alignment have been reported.
MATERIALS AND METHODS
This study included 127 women with osteoporosis aged more than 70 years. The correlation between lower-limb skeletal muscle index (SMI) and sagittal vertical axis (SVA) was calculated using radiographic measurements. Spinopelvic parameters, including SVA, sacral slope, pelvic tilt (PT), pelvic incidence, and lumbar lordosis, were measured. Lower-limb SMI was measured using whole-body dual-energy x-ray absorptiometry and calculated as SMI=nonfat mass/height2. The balance function was evaluated using the single-leg stance test. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests; significance level was set at P<0.05. Bivariate and multivariate logistic regression analyses were used to determine correlations.
RESULTS
Participants were classified into the balance and mismatch groups on the basis of a threshold SVA value of 50 mm. The groups did not differ significantly in age, height, weight, pelvic incidence, or sacral slope. Lumbar lordosis significantly decreased and PT and lower-limb SMI significantly increased in the mismatch group compared with the balance group. Lower-limb SMI was significantly correlated with increased SVA in bivariate and multivariate regression analyses. Patients with PT ≥20 degrees and SVA ≥50 mm had significantly increased lower-limb SMI.
CONCLUSIONS
Increased SVA is associated with increased lower-limb SMI, which negatively affects standing balance. An increased lower-limb SMI may represent a novel compensatory mechanism for poor spinal alignment in elderly women with osteoporosis.
LEVEL OF EVIDENCE
Level III.
Identifiants
pubmed: 32453163
pii: 01933606-202102000-00011
doi: 10.1097/BSD.0000000000001009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E19-E25Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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