Impact of spinal kyphosis on gastric myoelectrical activity in elderly patients with osteoporosis

Abstract

An association between spinal kyphosis and gastroesophageal reflux disease (GERD) was reported in recent years. However, it remains unclear whether spinal kyphosis affects gastric motility. We evaluated the changes in myoelectrical activity measured by electrogastrography (EGG) in elderly osteoporosis patients. A total of 18 patients scheduled for the treatment of osteoporosis were included in this study. They were analyzed by recording EGG to assess myoelectrical activity and heart rate variability (HRV) to evaluate the autonomic nervous system function before and after meals. Dominant power (DP) representing the strength of gastric electrical activity and dominant frequency (DF) representing its frequency were analyzed in blocks with a 5-minute duration. We divided the patients into 2 groups, thoracolumbar kyphosis (TLK) and non-TLK groups, and compared them. There were no significant differences between the 2 groups in background data. In the non-TLK group, DPs post 0-5 min were significantly higher than those during pre 5-0 min in channels 1 and 3 (P < 0.05 and P < 0.01). DF deviation in the TLK group was significantly higher than that in the non-TLK group at 10 to 15 postprandial minutes (P < 0.05). Low frequency/high frequency activity measured by HRV, reflecting the activity of the sympathetic nervous system, in the TLK group was significantly lower than that in the non-TLK group while eating (P < 0.01). The EGG of patients with spinal kyphotic deformity showed a similar change to that of patients with GERD; the spinal kyphotic deformity itself may affect gastric electrical activity.

Comparison of Outcomes between Minimally Invasive Lateral Approach Vertebral Reconstruction Using a Rectangular Footplate Cage and Conventional Procedure Using a Cylindrical Footplate Cage for Osteoporotic Vertebral Fracture

“…Correction loss is associated with kyphosis/pseudoarthrosis and increased implant failure/revision surgery; in addition, chronic pain, poor chest function, decreased appetite (gastroesophageal reflux disease [ 28 , 29 ]), and fatigue are more common in these patients [ 30 ]. To eliminate these potential risks, reconstructive AP surgery must prevent correction loss and achieve solid bony fusion.…”

Gravity and the Gut: A Hypothesis of Irritable Bowel Syndrome

“…If the spine begins to fail for any reason independent of GI pathology, then the abdominal crane will sag and the mesentery will descend, leading to altered angulation of the mesenteric root, pressurization of the peritoneal organs, and disrupted visceral function. For example, patients with kyphosis—a model of spinal gravity mismanagement—often report GI complaints from compression of the intra-abdominal organs and resultant dysmotility ( 18 ). Lordosis can also push abdominal contents forward, reducing anterior-posterior space and causing a protuberant abdomen ( 19 ).…”

“…This is what happens when the musculoskeletal structures that support the abdominal cavity are misshapen or break down. For example, GI symptoms are often reported in patients with kyphosis, lordosis, and vertebral compression fractures (18)(19)(20).…”

Pharmacologic treatment of GERD: Where we are now, and where are we going?

“…40,44 A positive correlation between the size of HH (an important contributing factor to GERD) and the severity of kyphosis has been found. 45 A recent paper 46 reported in patients with kyphosis a derangement of gastric myoelectric activity, which likely underlies a delay in gastric emptying. Being osteoporosis and kyphosis associated with GERD, patients are often under PPI treatment, but the increased risk of hip fracture (intrinsic to both conditions) is independent of PPI use.…”