ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022
Decreased muscle mass and strength affected spinal sagittal malalignment.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Association of paraspinal muscle morphology or composition with sagittal spinopelvic alignment: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- The impact of osteoporosis on preoperative presentation in adult spinal deformity patients undergoing surgical correction: a retrospective study.Spine deformity · 2026Article
- BMI as an Independent Determinant of Spinal Alignment in Degenerative Scoliosis.Diagnostics (Basel, Switzerland) · 2026Article
- Article
- The relative contribution of discs and vertebral bodies to thoracic kyphosis in healthy volunteers.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Biomechanical compensatory chain and residual compensation potential in aging spinal deformity: a narrative review and multimodal assessment framework.Frontiers in medicine · 2026Review
- Malnutrition and Spinal Sagittal Malalignment Are Risk Factors for Incidence of New Vertebral Fractures in Patients with Osteoporosis.Spine surgery and related research · 2025Article
- Machine learning can predict surgical indication: new clustering model from a large adult spine deformity database.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Spinal-Related Musculoskeletal Determinants of Functional Abdominal Bloating and Distension: A Narrative Review.Health science reports · 2025Article
- Posterior lumbar interbody fusion for degenerative spondylolisthesis; slippage reduction can be a risk factor for adjacent segment disease.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Muscle strength rather than appendicular skeletal muscle mass might affect spinal sagittal alignment, low back pain, and health-related quality of life.Scientific reports · 2023Article
Corrections and comments
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Authors and funding
32 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCorrection surgeries for spinal malalignment showed good clinical outcomes; however, there were concerns including increased invasiveness, complications, and impact on medico-economics. Ideally, an early intervention is needed. To better understand the patho-mechanism and natural course of spinal alignment, the effect of factors such as muscle mass and strength on spinal sagittal imbalance were determined in a multicenter cross-sectional study.
methodsAfter excluding metal implant recipients, 1823 of 2551 patients (mean age: 69.2 ± 13.8 years; men 768, women 1055) were enrolled. Age, sex, past medical history (Charlson comorbidity index), body mass index (BMI), grip strength (GS), and trunk muscle mass (TM) were reviewed. Spinal sagittal imbalance was determined by the SRS-Schwab classification. Multiple comparison analysis among four groups (Normal, Mild, Moderate, Severe) and multinomial logistic regression analysis were performed.
resultsOn multiple comparison analysis, with progressing spinal malalignment, age in both sexes tended to be higher; further, TM in women and GS in both sexes tended to be low. On multinomial logistic regression analysis, age and BMI were positively associated with spinal sagittal malalignment in Mild, Moderate, and Severe groups. TM in Moderate and Severe groups and GS in the Moderate group were negatively associated with spinal sagittal malalignment.
conclusionAging, obesity, low TM, and low GS are potential risk factors for spinal sagittal malalignment. Especially, low TM and low GS are potentially associated with more progressed spinal sagittal malalignment. Thus, early intervention for muscles, such as exercise therapy, is needed, while the spinal sagittal alignment is normal or mildly affected.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.