{"title":"躯干和四肢骨骼肌质量对成人脊柱畸形手术前后站立脊柱参数的影响，随访至少2年。","authors":"Tetsuro Ohba, Nobuki Tanaka, Kotaro Oda, Marina Katsu, Hayato Takei, Goto Go, Hirotaka Haro","doi":"10.1007/s00586-024-08617-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The effect of skeletal muscle mass of the trunk and extremities on sagittal imbalance of the spine before and after surgery for adult spinal deformity (ASD) has not been elucidated. The purpose of this study was to examine the correlation between reduced skeletal muscle mass of the trunk and extremities, as well as spinopelvic parameters, preoperatively, postoperatively and at least 2 years after surgery for ASD.</p><p><strong>Methods: </strong>This retrospective observational study included 140 consecutive patients who had undergone surgery for ASD and were followed-up for at least 2 years and whose skeletal muscle mass could be measured preoperatively using whole-body dual-energy X-ray absorptiometry. Correlations between skeletal muscle mass and spinopelvic parameters were assessed preoperatively, postoperatively, and after 2 years of follow-up.</p><p><strong>Results: </strong>All spinopelvic parameters were significantly improved postoperatively compared with preoperatively. Between the postoperative period and two years post-surgery, a significant loss of correction was observed in SVA and GT. Trunk muscles mass showed significant negative correlations with preoperative PT, SS, PI-LL, SVA, GT, and TPA, but there was no significant correlation with postoperative parameters. Through univariate and multivariate regression analysis, lower limb skeletal muscle mass showed a significant negative correlation with SVA at two years postoperatively and the loss of corrected SVA (ΔSVA) over two years.</p><p><strong>Conclusion: </strong>This study revealed that lower extremity muscle mass was implicated in the loss of corrected SVA 2 years after surgery. This study is clinically meaningful as it suggests that strength training for the lower extremities, performed preoperatively and/or postoperatively, can improve sagittal imbalances of the spine in patients with severe ASD or maintain SVA after corrective surgery.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of skeletal muscle mass of the trunk and extremities on standing spine parameters before and after surgery for adult spinal deformity with a minimum 2-year follow-up.\",\"authors\":\"Tetsuro Ohba, Nobuki Tanaka, Kotaro Oda, Marina Katsu, Hayato Takei, Goto Go, Hirotaka Haro\",\"doi\":\"10.1007/s00586-024-08617-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The effect of skeletal muscle mass of the trunk and extremities on sagittal imbalance of the spine before and after surgery for adult spinal deformity (ASD) has not been elucidated. The purpose of this study was to examine the correlation between reduced skeletal muscle mass of the trunk and extremities, as well as spinopelvic parameters, preoperatively, postoperatively and at least 2 years after surgery for ASD.</p><p><strong>Methods: </strong>This retrospective observational study included 140 consecutive patients who had undergone surgery for ASD and were followed-up for at least 2 years and whose skeletal muscle mass could be measured preoperatively using whole-body dual-energy X-ray absorptiometry. Correlations between skeletal muscle mass and spinopelvic parameters were assessed preoperatively, postoperatively, and after 2 years of follow-up.</p><p><strong>Results: </strong>All spinopelvic parameters were significantly improved postoperatively compared with preoperatively. Between the postoperative period and two years post-surgery, a significant loss of correction was observed in SVA and GT. Trunk muscles mass showed significant negative correlations with preoperative PT, SS, PI-LL, SVA, GT, and TPA, but there was no significant correlation with postoperative parameters. Through univariate and multivariate regression analysis, lower limb skeletal muscle mass showed a significant negative correlation with SVA at two years postoperatively and the loss of corrected SVA (ΔSVA) over two years.</p><p><strong>Conclusion: </strong>This study revealed that lower extremity muscle mass was implicated in the loss of corrected SVA 2 years after surgery. This study is clinically meaningful as it suggests that strength training for the lower extremities, performed preoperatively and/or postoperatively, can improve sagittal imbalances of the spine in patients with severe ASD or maintain SVA after corrective surgery.</p><p><strong>Level of evidence: 3: </strong></p>\",\"PeriodicalId\":12323,\"journal\":{\"name\":\"European Spine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-01-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00586-024-08617-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00586-024-08617-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Impact of skeletal muscle mass of the trunk and extremities on standing spine parameters before and after surgery for adult spinal deformity with a minimum 2-year follow-up.
Purpose: The effect of skeletal muscle mass of the trunk and extremities on sagittal imbalance of the spine before and after surgery for adult spinal deformity (ASD) has not been elucidated. The purpose of this study was to examine the correlation between reduced skeletal muscle mass of the trunk and extremities, as well as spinopelvic parameters, preoperatively, postoperatively and at least 2 years after surgery for ASD.
Methods: This retrospective observational study included 140 consecutive patients who had undergone surgery for ASD and were followed-up for at least 2 years and whose skeletal muscle mass could be measured preoperatively using whole-body dual-energy X-ray absorptiometry. Correlations between skeletal muscle mass and spinopelvic parameters were assessed preoperatively, postoperatively, and after 2 years of follow-up.
Results: All spinopelvic parameters were significantly improved postoperatively compared with preoperatively. Between the postoperative period and two years post-surgery, a significant loss of correction was observed in SVA and GT. Trunk muscles mass showed significant negative correlations with preoperative PT, SS, PI-LL, SVA, GT, and TPA, but there was no significant correlation with postoperative parameters. Through univariate and multivariate regression analysis, lower limb skeletal muscle mass showed a significant negative correlation with SVA at two years postoperatively and the loss of corrected SVA (ΔSVA) over two years.
Conclusion: This study revealed that lower extremity muscle mass was implicated in the loss of corrected SVA 2 years after surgery. This study is clinically meaningful as it suggests that strength training for the lower extremities, performed preoperatively and/or postoperatively, can improve sagittal imbalances of the spine in patients with severe ASD or maintain SVA after corrective surgery.
期刊介绍：
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe
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