Yoshiki Asai1, Shunji Tsutsui1, Noriko Yoshimura2, Hiroshi Hashizume1, Toshiko Iidaka2, Chiaki Horii2, Hiroshi Kawaguchi3, Kozo Nakamura4, Sakae Tanaka5, Munehito Yoshida1, Hiroshi Yamada1. 1. Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan. 2. Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan. 3. Department of Orthopedic Surgery, Tokyo Neurological Center, Tokyo, Japan. 4. Department of Orthopedic Surgery, Towa Hospital, Tokyo, Japan. 5. Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Abstract
PURPOSE: The demand for surgical correction in elderly patients with adult spinal deformity (ASD) has recently increased with the growth of the aging population. Age-related changes in spinopelvic sagittal alignment have been recently reported; thus, sagittal realignment should consider age-related changes. This study aimed to investigate the relationship between age-specific sagittal spinopelvic radiographic parameters and low back pain (LBP) to support the establishment of age-specific realignment targets for patients with ASD. MATERIALS AND METHODS: A population-based cohort consisting of 1461 subjects (466 men and 995 women) was used. The participants were divided into five groups based on their age: (1) younger than 50 years, (2) 50-59 years, (3) 60-69 years, (4) 70-79 years, and (5) 80 years and older. Standing lateral whole-spine radiographs were assessed to measure lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and sagittal vertical axis (SVA). In addition, all participants were asked if they had LBP or not, using the following question: "Have you experienced LBP on most days during the past month and/or now?". RESULTS: The crucial parameter associated with LBP was the mismatch between PI and LL (PI-LL). The mean values of all the radiographic parameters increased with age. PI-LL and PT reached 11.5° and 25.6°, respectively, for women without LBP in the super-aged group (age >80 years), which did not lie in the range of optimal values reported in the previous literature. CONCLUSION: A new optimal age-related target may be needed for the management of patients with ASD.
PURPOSE: The demand for surgical correction in elderly patients with adult spinal deformity (ASD) has recently increased with the growth of the aging population. Age-related changes in spinopelvic sagittal alignment have been recently reported; thus, sagittal realignment should consider age-related changes. This study aimed to investigate the relationship between age-specific sagittal spinopelvic radiographic parameters and low back pain (LBP) to support the establishment of age-specific realignment targets for patients with ASD. MATERIALS AND METHODS: A population-based cohort consisting of 1461 subjects (466 men and 995 women) was used. The participants were divided into five groups based on their age: (1) younger than 50 years, (2) 50-59 years, (3) 60-69 years, (4) 70-79 years, and (5) 80 years and older. Standing lateral whole-spine radiographs were assessed to measure lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and sagittal vertical axis (SVA). In addition, all participants were asked if they had LBP or not, using the following question: "Have you experienced LBP on most days during the past month and/or now?". RESULTS: The crucial parameter associated with LBP was the mismatch between PI and LL (PI-LL). The mean values of all the radiographic parameters increased with age. PI-LL and PT reached 11.5° and 25.6°, respectively, for women without LBP in the super-aged group (age >80 years), which did not lie in the range of optimal values reported in the previous literature. CONCLUSION: A new optimal age-related target may be needed for the management of patients with ASD.
Authors: Frank Schwab; Benjamin Ungar; Benjamin Blondel; Jacob Buchowski; Jeffrey Coe; Donald Deinlein; Christopher DeWald; Hossein Mehdian; Christopher Shaffrey; Clifford Tribus; Virginie Lafage Journal: Spine (Phila Pa 1976) Date: 2012-05-20 Impact factor: 3.468
Authors: Renaud Lafage; Frank Schwab; Vincent Challier; Jensen K Henry; Jeffrey Gum; Justin Smith; Richard Hostin; Christopher Shaffrey; Han J Kim; Christopher Ames; Justin Scheer; Eric Klineberg; Shay Bess; Douglas Burton; Virginie Lafage Journal: Spine (Phila Pa 1976) Date: 2016-01 Impact factor: 3.468
Authors: Clermont E Dionne; Kate M Dunn; Peter R Croft; Alf L Nachemson; Rachelle Buchbinder; Bruce F Walker; Mary Wyatt; J David Cassidy; Michel Rossignol; Charlotte Leboeuf-Yde; Jan Hartvigsen; Päivi Leino-Arjas; Ute Latza; Shmuel Reis; Maria Teresa Gil Del Real; Francisco M Kovacs; Birgitta Oberg; Christine Cedraschi; Lex M Bouter; Bart W Koes; H Susan J Picavet; Maurits W van Tulder; Kim Burton; Nadine E Foster; Gary J Macfarlane; Elaine Thomas; Martin Underwood; Gordon Waddell; Paul Shekelle; Ernest Volinn; Michael Von Korff Journal: Spine (Phila Pa 1976) Date: 2008-01-01 Impact factor: 3.468
Authors: S Muraki; H Oka; T Akune; A Mabuchi; Y En-Yo; M Yoshida; A Saika; T Suzuki; H Yoshida; H Ishibashi; S Yamamoto; K Nakamura; H Kawaguchi; N Yoshimura Journal: Ann Rheum Dis Date: 2008-08-21 Impact factor: 19.103
Authors: Leevi A Toivonen; Heikki Mäntymäki; Arja Häkkinen; Hannu Kautiainen; Marko H Neva Journal: Spine (Phila Pa 1976) Date: 2022-07-01 Impact factor: 3.241