Body Compositional Characteristics in Geriatric Nonspecific Low Back Pain
2021 Volume 12 Issue 5 Pages 686-693
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2021 Volume 12 Issue 5 Pages 686-693
Introduction: Although the prevalence and associated burden of low back pain (LBP) increase with age, research on LBP has primarily focused on young people and adults and little attention has been given to the elderly population. It has been reported that sarcopenia is common in elderly patients with chronic low back pain (CLBP); however, no evidence was observed that implies the associated mechanism of skeletal muscle mass reduction in chronic pain. Furthermore, no senescence-associated pain mechanism has been evaluated in the development of LBP. We investigated body compositional relevance, including skeletal muscle and fat volume, to global spinal alignment in elderly patients with CLBP.
Methods: Prospective data collection including laboratory analysis in hematological and biochemical test, vitamin D (25-OHD), body compositional measurement by whole-body dual-energy X-ray absorptiometry (DXA) to evaluate skeletal muscle and fat mass, global spinal sagittal alignment by plane radiograph and cross-sectional area of trunk muscle by magnetic resonance imaging (MRI) in the lumbar spine were obtained on 195 elderly patients with CLBP (averaged 79.1 years). Comparison was made by age- and sex-adjusted propensity score matching with the elderly control group.
Results: In CLBP, vitamin D was significantly low, red blood cell distribution width (RDW) was high, and lower skeletal muscle mass and higher fat volume with lower trunk muscle mass were observed. There were no significant differences between the two groups in lumbar disk and endplate degeneration; however, global spinal sagittal alignment showed CLBP with decreased lumbar lordosis, sagittal plane, and pelvic spinal imbalance.
Conclusions: RDW, which is an index of aging, was high among elderly patients with CLBP. In addition, it is considered that the presence of hypovitaminosis D in CLBP affects the pain threshold for geriatric nociception. Furthermore, age-related muscle mass reduction has potential for spinal and pelvic imbalance, leading to CLBP in the elderly. Elucidation of the mechanism of senescence may shed light on the novel procedure for CLBP.
