Kazuhiro Hasegawa1, Shun Hatsushikano2, Kei Watanabe3, Masayuki Ohashi3, Jean Dubousset4. 1. Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata City, 950-0165, Japan. kazu3795jp@yahoo.co.jp. 2. Niigata Spine Surgery Center, 2-5-22 Nishi-machi, Niigata City, 950-0165, Japan. 3. Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan. 4. Académie Nationale de Médecine, 16 Rue Bonaparte, 75006, Paris, France.
Abstract
PURPOSE: Aging and spinal disease impair standing whole body sagittal alignment (WBS alignment), which leads to stooping. When WBS alignment deteriorates, compensatory mechanisms are activated to maintain standing posture. Increase of the compensation impairs health-related quality of life (HRQOL). The purpose of this research was to determine whether postural factors, age, and sex affect HRQOL. METHODS: This cross-sectional study evaluated the influence of WBS alignment, standing body sway (balance), skeletal muscle mass (SMM), aging, and sex on HRQOL in healthy volunteers (n = 150; mean age 40.9 years [20-76], 96 women). Age, sex, weight, height, and body mass index (BMI) were obtained. HRQOL was assessed with Scoliosis Research Society-22 (SRS-22r). WBS alignment and balance were measured by EOS imaging with simultaneous force plate measurement. SMM was measured using a medical body composition analyzer. Based on the bivariate analysis between the SRS-22r subtotal and all parameters, selected ten parameters were used for multivariate logistic regression analysis to identify affecting factors to SRS-22r. RESULTS: Men had significantly higher weight, height, BMI, and SRS-22r score in all domains. The L4-S1 lumbar lordosis angle was greater in men, and pelvic tilt and knee hyperextension were greater in women. Women had a more stable standing posture, whereas men had significantly higher SMM values. Multivariate logistic regression analysis revealed that age, sex, and TPA were identified as significant factors affecting SRS-22r. CONCLUSIONS: In healthy volunteers, SRS-22r is affected by aging, sex (woman had a lower score), and sagittal malalignment. Neither Standing balance nor SMM, however, affect SRS-22r.4.
PURPOSE: Aging and spinal disease impair standing whole body sagittal alignment (WBS alignment), which leads to stooping. When WBS alignment deteriorates, compensatory mechanisms are activated to maintain standing posture. Increase of the compensation impairs health-related quality of life (HRQOL). The purpose of this research was to determine whether postural factors, age, and sex affect HRQOL. METHODS: This cross-sectional study evaluated the influence of WBS alignment, standing body sway (balance), skeletal muscle mass (SMM), aging, and sex on HRQOL in healthy volunteers (n = 150; mean age 40.9 years [20-76], 96 women). Age, sex, weight, height, and body mass index (BMI) were obtained. HRQOL was assessed with Scoliosis Research Society-22 (SRS-22r). WBS alignment and balance were measured by EOS imaging with simultaneous force plate measurement. SMM was measured using a medical body composition analyzer. Based on the bivariate analysis between the SRS-22r subtotal and all parameters, selected ten parameters were used for multivariate logistic regression analysis to identify affecting factors to SRS-22r. RESULTS: Men had significantly higher weight, height, BMI, and SRS-22r score in all domains. The L4-S1 lumbar lordosis angle was greater in men, and pelvic tilt and knee hyperextension were greater in women. Women had a more stable standing posture, whereas men had significantly higher SMM values. Multivariate logistic regression analysis revealed that age, sex, and TPA were identified as significant factors affecting SRS-22r. CONCLUSIONS: In healthy volunteers, SRS-22r is affected by aging, sex (woman had a lower score), and sagittal malalignment. Neither Standing balance nor SMM, however, affect SRS-22r.4.