Matsuo S1, Minetama M1, Nakagawa M1, Yamamoto Y1, Koike Y1, Sakon N1, Nakatani T1, Sumiya T1, Nakagawa Y1, Teraguchi M1, Kagotani R1, Mera Y1, Kitano T1, Kawakami M1
1Wakayama Medical University Kihoku Hospital, Spine Care Center, Katsuragi-cho, Ito-gun, Japan
Background: Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength that is associated with numerous adverse outcomes such as falls, fractures, frailty, and mortality. Several factors, including aging, physical inactivity, malnutrition, and comorbidity, contribute to the development of sarcopenia. However, degenerative cervical and lumbar spine disease are common conditions in older people. Pain caused by spinal diseases contributes to physical inactivity and disuse. It has been reported that patients with lumbar spinal stenosis (LSS) and drop-head syndrome have a higher prevalence of sarcopenia compared with healthy controls. However, the prevalence of sarcopenia in patients with cervical spondylotic myelopathy (CSM) has not been investigated.
Purpose: The purpose of this study was to investigate the prevalence of sarcopenia and compare its clinical features between patients with CSM and LSS.
Methods: Patients diagnosed with CSM or LSS at the Spine Care Center, Wakayama Medical University Kihoku Hospital, were enrolled from September 2017 to April 2018. Body composition was assessed using bioelectrical impedance with a body composition meter (InBody S10; BioSpace, Seoul, Korea). We collected data in regard to hand grip strength, 5-m gait speed, the 36-item Short-Form Survey (SF-36), a numerical rating scale of pain and numbness, and radiographic measurements (C7 plumb line, side curvature Cobb angle, sagittal vertical axis, thoracic kyphotic angle, lumbar lordosis angle, sacral slope, pelvic incidence, pelvic tilt, number of vertebral fractures, and bone mineral density [BMD]). We defined sarcopenia using the Asian Working Group for Sarcopenia criteria as grip strength 26 kg for men and 18 kg for women and/or gait speed 0.8 m/s and skeletal muscle mass index 7.0 kg/m2 for men and 5.7 kg/m2 for women. The prevalence of sarcopenia and clinical outcomes were compared between the CSM and LSS groups. P-values 0.05 were considered significant.
Results: In total, 32 patients with CSM and 172 patients with LSS were enrolled. The CSM (average age: 72.7 y; 22 men, 8 women) and LSS (average age: 73.0 y; 22 men, 8 women) groups were composed of selected age- and gender-matched patients. The prevalence of sarcopenia was 43.3% in the CSM and 10% in the LSS group (P = 0.004). Skeletal muscle mass index (CSM: 6.54 kg/m2 vs LSS: 7.24 kg/m2), grip strength (CSM: 23.1 kg vs LSS: 30.1 kg), and walking speed (CSM: 0.95 m/s vs LSS: 1.0 m/s) were significantly lower for the CSM than for the LSS group (P 0.05). No significant differences were observed between groups in quality of life (QOL) as measured by the SF-36, pain, spinal alignment, or BMD (P ≥ 0.05).
Conclusion(s): The prevalence of sarcopenia was four times higher in patients with CSM than in patients with LSS. However, no differences were seen in QOL or pain between the two groups.
Implications: It is important to prevent the progression of sarcopenia and the decline of QOL in patients with CSM. Lifestyle approaches, including physical activity, nutrition, and living environment, are needed for patients with CSM.
Keywords: Sarcopenia, cervical spondylotic myelopathy, lumbar spinal stenosis
Funding acknowledgements: We have no funding in this study.
Purpose: The purpose of this study was to investigate the prevalence of sarcopenia and compare its clinical features between patients with CSM and LSS.
Methods: Patients diagnosed with CSM or LSS at the Spine Care Center, Wakayama Medical University Kihoku Hospital, were enrolled from September 2017 to April 2018. Body composition was assessed using bioelectrical impedance with a body composition meter (InBody S10; BioSpace, Seoul, Korea). We collected data in regard to hand grip strength, 5-m gait speed, the 36-item Short-Form Survey (SF-36), a numerical rating scale of pain and numbness, and radiographic measurements (C7 plumb line, side curvature Cobb angle, sagittal vertical axis, thoracic kyphotic angle, lumbar lordosis angle, sacral slope, pelvic incidence, pelvic tilt, number of vertebral fractures, and bone mineral density [BMD]). We defined sarcopenia using the Asian Working Group for Sarcopenia criteria as grip strength 26 kg for men and 18 kg for women and/or gait speed 0.8 m/s and skeletal muscle mass index 7.0 kg/m2 for men and 5.7 kg/m2 for women. The prevalence of sarcopenia and clinical outcomes were compared between the CSM and LSS groups. P-values 0.05 were considered significant.
Results: In total, 32 patients with CSM and 172 patients with LSS were enrolled. The CSM (average age: 72.7 y; 22 men, 8 women) and LSS (average age: 73.0 y; 22 men, 8 women) groups were composed of selected age- and gender-matched patients. The prevalence of sarcopenia was 43.3% in the CSM and 10% in the LSS group (P = 0.004). Skeletal muscle mass index (CSM: 6.54 kg/m2 vs LSS: 7.24 kg/m2), grip strength (CSM: 23.1 kg vs LSS: 30.1 kg), and walking speed (CSM: 0.95 m/s vs LSS: 1.0 m/s) were significantly lower for the CSM than for the LSS group (P 0.05). No significant differences were observed between groups in quality of life (QOL) as measured by the SF-36, pain, spinal alignment, or BMD (P ≥ 0.05).
Conclusion(s): The prevalence of sarcopenia was four times higher in patients with CSM than in patients with LSS. However, no differences were seen in QOL or pain between the two groups.
Implications: It is important to prevent the progression of sarcopenia and the decline of QOL in patients with CSM. Lifestyle approaches, including physical activity, nutrition, and living environment, are needed for patients with CSM.
Keywords: Sarcopenia, cervical spondylotic myelopathy, lumbar spinal stenosis
Funding acknowledgements: We have no funding in this study.
Topic: Musculoskeletal: spine
Ethics approval required: Yes
Institution: Wakayama Medical University
Ethics committee: Institutional Review Broard of Wakayama Medical University
Ethics number: 2378
All authors, affiliations and abstracts have been published as submitted.
