Spine-specific sarcopenia: distinguishing paraspinal muscle atrophy from generalized sarcopenia

Atrophy of the paraspinal musculature (PM) as well as generalized sarcopenia are increasingly reported as important parameters for clinical outcomes in the field of spine surgery. Despite growing awareness and potential similarities between both conditions, the relationship between “generalized” and...

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Published in:The spine journal 2024-07, Vol.24 (7), p.1211-1221
Main Authors: Schönnagel, Lukas, Chiaparelli, Erika, Camino-Willhuber, Gaston, Zhu, Jiaqi, Caffard, Thomas, Tani, Soji, Burkhard, Marco D., Kelly, Michael, Guven, Ali E., Shue, Jennifer, Sama, Andrew A., Girardi, Federico P., Cammisa, Frank P., Hughes, Alexander P.
Format: Article
Language:English
Subjects:
EGWSOP2
Grip strength
Paraspinal musculature
Psoas index
Sarcopenia
Spine-specific sarcopenia
SPPB
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Summary:Atrophy of the paraspinal musculature (PM) as well as generalized sarcopenia are increasingly reported as important parameters for clinical outcomes in the field of spine surgery. Despite growing awareness and potential similarities between both conditions, the relationship between “generalized” and “spine-specific” sarcopenia is unclear. To investigate the association between generalized and spine-specific sarcopenia. Retrospective cross-sectional study. Patients undergoing lumbar spinal fusion surgery for degenerative spinal pathologies. Generalized sarcopenia was evaluated with the short physical performance battery (SPPB), grip strength, and the psoas index, while spine-specific sarcopenia was evaluated by measuring fatty infiltration (FI) of the PM. We used custom software written in MATLAB® to calculate the FI of the PM. The correlation between FI of the PM and assessments of generalized sarcopenia was calculated using Spearman's rank correlation coefficient (rho). The strength of the correlation was evaluated according to established cut-offs: negligible: 0–0.3, low: 0.3–0.5, moderate: 0.5–0.7, high: 0.7–0.9, and very high≥0.9. In a Receiver Operating Characteristics (ROC) analysis, the Area Under the Curve (AUC) of sarcopenia assessments to predict severe multifidus atrophy (FI≥50%) was calculated. In a secondary analysis, factors associated with severe multifidus atrophy in nonsarcopenic patients were analyzed. A total of 125 (43% female) patients, with a median age of 63 (IQR 55–73) were included. The most common surgical indication was lumbar spinal stenosis (79.5%). The median FI of the multifidus was 45.5% (IQR 35.6–55.2). Grip strength demonstrated the highest correlation with FI of the multifidus and erector spinae (rho=-0.43 and -0.32, p
ISSN:1529-9430
1878-1632
1878-1632
DOI:10.1016/j.spinee.2024.02.021