ISSLS PRIZE IN CLINICAL SCIENCE 2019: clinical importance of trunk muscle mass for low back pain, spinal balance, and quality of life—a multicenter cross-sectional study

• Published in: European spine journal Vol. 28; no. 5; pp. 914 - 921
• Main Authors: Hori, Yusuke, Hoshino, Masatoshi, Inage, Kazuhide, Miyagi, Masayuki, Takahashi, Shinji, Ohyama, Shoichiro, Suzuki, Akinobu, Tsujio, Tadao, Terai, Hidetomi, Dohzono, Sho, Sasaoka, Ryuichi, Toyoda, Hiromitsu, Kato, Minori, Matsumura, Akira, Namikawa, Takashi, Seki, Masahiko, Yamada, Kentaro, Habibi, Hasibullah, Salimi, Hamidullah, Yamashita, Masaomi, Yamauchi, Tomonori, Furuya, Takeo, Orita, Sumihisa, Maki, Satoshi, Shiga, Yasuhiro, Inoue, Masahiro, Inoue, Gen, Fujimaki, Hisako, Murata, Kosuke, Kawakubo, Ayumu, Kabata, Daijiro, Shintani, Ayumi, Ohtori, Seiji, Takaso, Masashi, Nakamura, Hiroaki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2019; Springer Nature B.V
• Subjects: Aged; Back pain; Body Composition - physiology; Body mass index; Cross-Sectional Studies; Demography; Disability Evaluation; Electric Impedance; Female; Humans; Low back pain; Low Back Pain - physiopathology; Male; Medicine; Medicine & Public Health; Muscle, Skeletal - physiology; Neurosurgery; Original Article; Pain; Postural Balance - physiology; Quality of Life; Radiography; Sarcopenia; Skeletal muscle; Spine (lumbar); Spine - diagnostic imaging; Spine - physiology; Surgery; Surgical Orthopedics; Torso - physiology; Visual Analog Scale; Vital signs; Sarcopenia; Trunk muscles; Kyphosis; Lumbar spine; Low back pain
• ISSN: 0940-6719; 1432-0932; 1432-0932
• DOI: 10.1007/s00586-019-05904-7

Study design A multicenter cross-sectional study. Objectives To clarify the relationship of trunk muscle mass with low back pain, spinal sagittal balance, and quality of life. Summary of background data Few reports have investigated the relationship of trunk muscle mass with lumbar spine function and spinal balance, and the clinical significance of trunk muscle mass remains unclear. Methods Patients attending spinal outpatient clinics at 10 different medical institutions were enrolled in this study. Patient demographics, trunk muscle mass and appendicular skeletal muscle mass (ASM) measured by bioelectrical impedance analysis (BIA), body mass index (BMI), Charlson Comorbidity Index (CCI), the Oswestry Disability Index (ODI), visual analog scale (VAS) for low back pain, sagittal vertical axis (SVA), and EuroQol 5 Dimension (EQ5D) score were investigated. Multivariate nonlinear regression analysis was used to investigate the association of trunk muscle mass with the ODI, VAS score, SVA, and EQ5D score. Results Of 2551 eligible patients, 1738 (mean age 70.2 ± 11.0 years; 781 men and 957 women) were enrolled. Trunk muscle mass was significantly correlated with the ODI, VAS score, SVA, and EQ5D score ( P  < 0.001) when adjusted for age, sex, BMI, ASM, CCI, and history of lumbar surgery. Patient deterioration was associated with a decrease in trunk muscle mass, and the deterioration accelerated from approximately 23 kg. Conclusions Trunk muscle mass was significantly associated with the ODI, VAS score, SVA, and EQ5D score. Trunk muscle mass may assume an important role to elucidate and treat lumbar spinal dysfunction and spinal imbalance. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.