Age-Related Spinal Deformity: a Consequence of Sarcopenia?

Article: Sarcopenia, Ectopic Fat Infiltration Into the Lumbar Paravertebral Muscles, and Lumbo-Pelvic Deformity in Older Adults Undergoing Lumbar Surgery

Characterised by the loss of skeletal muscle mass and function, sarcopenia begins to present itself in individuals over 40 years of age. Muscles supporting posture maintenance and core body extension, however, are affected earlier. Sarcopenia’s impact on lumbar paravertebral muscles (PVM), crucial supporters of core body extension, may thus contribute to the onset of ageing-related spine deformity. In spite of this hypothesis, the link between sarcopenia and age-related lumbopelvic deformity remains uniquely understudied.

This study aimed to evaluate the relationship between PVM quality and volume, sarcopenia, and lumbopelvic deformity in a cohort of older adults having undergone lumbar surgery.

Key learnings:

Compared to their non-sarcopenic counterparts, patients with sarcopenia possessed greater pelvic tilt and incidence minus lumbar lordosis values, but smaller PVM areas. Skeletal muscle volume loss, including PVM, is therefore negatively correlated with lumbar kyphosis and posterior pelvic tilts – two indicators of spinal deformity. Moreover, patients with sarcopenia possessed greater Goutallier grades than non-sarcopenic older adults, reflecting a higher amount of ectopic fat in PVM. The link between skeletal muscle index and ectopic fat also manifested itself genetically, with sarcopenic patients exhibiting upregulated Pparg and Cebpa gene expression correlating with Goutallier grade. Ultimately, these findings reveal a negative correlation between age-related lumbopelvic deformity and sarcopenia-associated ectopic fat infiltration (and not atrophy) in PVM.

Reviewed by: S. Duarte