Clinical, physical, and radiographic analyses of lumbar degenerative kyphosis and spondylolisthesis among community-based cohort

Kobayashi, Tetsuya; Chiba, Hisashi; Jimbo, Shizuo; Senoo, Issei; Shimizu, Mutsuya; Atsuta, Yuji; Ito, Hiroshi; Sugisawa, Hiroyuki; Sugawara, Toshinobu; Habaguchi, Tatsuya

doi:10.1007/s00586-016-4615-0

Cited by 20 publications

(16 citation statements)

References 16 publications

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“…There was no significant change in the values for TK over 34 years, which is similar to the findings of Kobayashi et al who also reported small changes in TK over their study period of 12.3 years [4]. On the other hand, Diebo et al reported a wider range for TK, with spinal malalignment ranging from hyper-to hypokyphosis [27], Fig.…”

Section: Discussionsupporting

confidence: 87%

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Adult spinal deformity and its relationship with height loss: a 34-year longitudinal cohort study

Shimizu

Kobayashi

Chiba³

et al. 2020

BMC Musculoskelet Disord

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Background: Age-related height loss is a normal physical change that occurs in all individuals over 50 years of age. Although many epidemiological studies on height loss have been conducted worldwide, none have been longterm longitudinal epidemiological studies spanning over 30 years. This study was designed to investigate changes in adult spinal deformity and examine the relationship between adult spinal deformity and height loss. Methods: Fifty-three local healthy subjects (32 men, 21 women) from Furano, Hokkaido, Japan, volunteered for this longitudinal cohort study. Their heights were measured in 1983 and again in 2017. Spino-pelvic parameters were compared between measurements obtained in 1983 and 2017. Individuals with height loss were then divided into two groups, those with degenerative spondylosis and those with degenerative lumbar scoliosis, and different characteristics were compared between the two groups. Results: The mean age of the subjects was 44.4 (31-55) years at baseline and 78.6 (65-89) years at the final followup. The mean height was 157.4 cm at baseline and 153.6 cm at the final follow-up, with a mean height loss of 3.8 cm over 34.2 years. All parameters except for thoracic kyphosis were significantly different between measurements taken in 1983 and 2017 (p < 0.05). Height loss in both sexes was related to changes in pelvic parameters including pelvic incidence-lumbar lordosis (R = 0.460 p = 0.008 in men, R = 0.553 p = 0.012 in women), pelvic tilt (R = 0.374 p = 0.035 in men, R = 0.540 p = 0.014 in women), and sagittal vertical axis (R = 0.535 p = 0.002 in men, R = 0.527 p = 0.017 in women). Greater height loss was more commonly seen in women (p = 0.001) and in patients with degenerative lumbar scoliosis (p = 0.02). Conclusions: This longitudinal study revealed that height loss is more commonly observed in women and is associated with adult spinal deformity and degenerative lumbar scoliosis. Height loss is a normal physical change with aging, but excessive height loss is due to spinal kyphosis and scoliosis leading to spinal malalignment. Our findings suggest that height loss might be an early physical symptom for spinal malalignment.

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Section: Discussionsupporting

confidence: 87%

“…The ultimate aim of ASD treatment, even in younger patients, is to ensure that patients are ambulant without requiring a cane or handrail for support. ASD affects muscular strength leading to changes in the range of motion of the trunk, lower extremities, and the whole body [4,5].…”

Section: Introductionmentioning

confidence: 99%

Adult spinal deformity and its relationship with height loss: a 34-year longitudinal cohort study

Shimizu

Kobayashi

Chiba³

et al. 2020

BMC Musculoskelet Disord

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“…Additionally, Aono et al [83] followed up for 12.1 years (8–14 years) in 142 female subjects without spondylolisthesis at baseline radiographs (mean baseline age: 54.7 years, range: 40–77yrs), and the incidence of newly developed DS was 12.7%. The same group [84] reported when the female participants were 68.5 ± 9.2 years old, the DS prevalence was 24.8% (50 participants out of 289). These data suggest that elderly Japanese females and elderly Chinese females in Hong Kong have similar DS prevalence and progression rates.…”

Section: Epidemiology I: Results Of Population Based Studiessupporting

confidence: 56%

Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence

Wáng

Káplár

Deng

et al. 2017

Journal of Orthopaedic Translation

159

144

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SummaryThe epidemiology of lumbar degenerative spondylolisthesis (DS) remains controversial. We performed a systematic review with the aim of gaining a better understanding of the prevalence of DS in the general population. The results showed that the prevalence of DS is very gender- and age-specific. Few women and men develop DS before they are 50 years old. After 50 years of age, both women and men begin to develop DS, with women having a faster rate of development than men. For elderly Chinese (≥ 65 years, mean age: 72.5 years), large population-based studies MsOS (Hong Kong, females: n = 2000) and MrOS (Hong Kong, males: n = 2000) showed DS prevalence was 25.0% in women and 19.1% in men. The female:male (F:M) prevalence ratio was 1.3:1. The published data for MsOS (USA) and MrOS (USA) studies seem to show that elderly Caucasian Americans have a higher DS prevalence, being approximately 60–70% higher than elderly Chinese; however, the F:M prevalence ratio was similar to the elderly Chinese population. Patient data showed that female patients more often received surgical treatment than male and preliminary data showed the ratio of female to male patients receiving surgical treatment did not differ between Northeast Asians (Chinese, Japanese, and Korean), Europeans, and American Caucasians, being around 2:1 in the elderly population. The existing data also suggest that menopause may be a contributing factor for the accelerated development of DS in postmenopausal women.The translational potential of this article: A better understanding of epidemiology of lumbar degenerative spondylolisthesis can support patient consultation and treatment planning.

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“…To date, ASD studies have focused on the static deformity using upright entire spine radiographs 2,4 , and modalities to evaluate dynamic ambulatory kyphosis are scarce. We reported changes in trunk angle using digitally captured gait postures 5 and found some characteristic changes in arm swing among elderly participants that had not been previously elaborated.…”

Section: Introductionmentioning

confidence: 96%

Classification of arm swing as a clinical marker of advancing spinal deformity among community-dwelling female volunteers 60 years or older

Kobayashi

Jimbo

Senoo

et al. 2019

Sci Rep

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The clinical characteristics of adult spinal deformity (ASD) include worsening of deformity during gait, which leads to unstable posture and propensity to fall. The purpose of this study was to classify arm swing and to analyse its clinical implications. Clinical and radiographic evaluations were performed with 168 community-dwelling female volunteers recruited from a population register in Hokkaido, Japan, with a mean age of 67.3 ± 4.7 years, and arm swing was classified into four groups according to maximum forward and backward arm swing distance: (1) predominantly forward swing with forward swing always larger than backward swing (FS, n = 138), (2) equal or equivocal swing (ES, n = 8), (3) predominantly backward swing with backward swing always larger than forward swing (BS, n = 20), and (4) thigh-hand type without arm swing with their hands placed on thighs (TH, n = 2). BS and FS showed significant differences in radiographic lumbar lordosis (BS 19.4 ± 18.1° vs. FS 40.6 ± 14.5°, P < 0.01 ANOVA), pelvic tilt (BS 40.0 ± 7.3° vs. FS 22.9 ± 8.9°, p < 0.01), number of vertebral fractures (BS 1.2 ± 1.4 vs. FS 0.3 ± 0.6, p < 0.01), and trunk extensor muscle strength (BS 374.9 ± 134.8 N vs. FS 478.1 ± 172.6 N, p < 0.05). Arm swing correlated with severity of radiographic ASD, osteoporotic changes, and back muscle weakness. The number of ASD patients, which includes patients with de novo /idiopathic scoliosis, degenerative/osteoporotic kyphosis, and other neuromuscular deformities, has been increasing, and further study should clarify the importance of dynamic evaluation of ASD among elderly patients.

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Clinical, physical, and radiographic analyses of lumbar degenerative kyphosis and spondylolisthesis among community-based cohort

Cited by 20 publications

References 16 publications

Adult spinal deformity and its relationship with height loss: a 34-year longitudinal cohort study

Adult spinal deformity and its relationship with height loss: a 34-year longitudinal cohort study

Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence

Classification of arm swing as a clinical marker of advancing spinal deformity among community-dwelling female volunteers 60 years or older

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