Sarcopenia, Ectopic Fat Infiltration Into the Lumbar Paravertebral Muscles, and Lumbo-Pelvic Deformity in Older Adults Undergoing Lumbar Surgery
Autor: | Kiyoshi Higa, Deokcheol Lee, Syuji Kurogi, Keisuke Kawano, Hideaki Hamanaka, Takuya Nagai, Tomofumi Kuroki, Etsuo Chosa |
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Rok vydání: | 2021 |
Předmět: |
Pelvic tilt
Sarcopenia medicine.medical_specialty ectopic fat infiltration Pparg skeletal muscle volume Urology Clinical Case Series Lumbar atrophy parasitic diseases medicine Deformity Humans cebpa Orthopedics and Sports Medicine Prospective Studies Goutallier classification older adults Aged Retrospective Studies atrogin-1 Core (anatomy) Lumbar Vertebrae medicine.diagnostic_test business.industry Muscles Skeletal muscle Magnetic resonance imaging medicine.disease Trunk Murf1 spine-pelvic deformity body regions medicine.anatomical_structure lumbar paravertebral muscles Lordosis Neurology (clinical) medicine.symptom business |
Zdroj: | Spine |
ISSN: | 1528-1159 0362-2436 |
Popis: | The volume loss of skeletal muscle, including lumbar paravertebral muscles, is negatively correlated with the rate of lumbo-pelvic deformity. Moreover, ectopic fat infiltration with highly expressed adipogenesis promoting genes in the paravertebral muscles may reflect pathology of sarcopenia and may cause age-related lumbo-pelvic deformity. Study Design. A retrospective analysis of a prospective, non-randomized cohort dataset. Objective. To cross-sectionally examine the prevalence of sarcopenia and the association between spine-pelvic deformity and skeletal muscle volume loss and ectopic fat infiltration into lumbar paravertebral muscles (PVMs) in patients who underwent lumbar surgery. Summary of Background Data. Muscle quality deterioration has been considered the main pathology of sarcopenia, reducing muscle strength directly. The qualitative deterioration as well as volume loss in PVM, which contributes significantly to core body extension, might cause aging-related spine deformity. Methods. In total, 184 patients were included. Sarcopenia was diagnosed at baseline, and all patients underwent whole-body X-ray. The amount of fat in lumbar PVM was evaluated with the Goutallier classification in magnetic resonance imaging findings. The expression of adipogenesis- and atrophy-promoting factors in PVM was evaluated with quantitative polymerase chain reaction. Results. In total, 36.1% of adults aged ≥60 years were diagnosed with sarcopenia. The values of skeletal muscle indexes of the limb and trunk were inversely correlated with the sagittal vertical axis, pelvic tilt (PT), and pelvic incidence minus lumbar lordosis (PI-LL) values. The PT and PI-LL were greater, PVM area was smaller, and Goutallier grade was greater in sarcopenic adults than in non-sarcopenic older adults. Additionally, the PVM area correlated with the LL value, and Goutallier's grade correlated with the PT and PI-LL values. Moreover, the amount of ectopic fat in PVMs inversely correlated with skeletal muscle indexes. The expression levels of atrophy gene-1 and muscle ring-finger protein-1 did not differ between the groups and did not correlate with the PVM area. In contrast, the expression of Pparg and Cebpa was upregulated in sarcopenic older adults, where it correlated with Goutallier's grade. Conclusion. The volume loss of skeletal muscle, including lumbar PVM, and ectopic fat infiltration into the PVM, may cause the lumbo-pelvic deformity. Level of Evidence: 3 |
Databáze: | OpenAIRE |
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