Patients with osteoporosis often showed round back due to vertebral fractures and gastroesophageal reflux disease (Gerd) symptoms due to increase in abdominal pressure. We hypothesized that spinal sagittal malalignment in osteoporosis patients might be associated with Gerd symptoms, and then investigated the prevalence of Gerd symptoms or spinal sagittal malalignment and the relationship between them. 137 osteoporosis patients aged more than 60 years were included in the current study. We evaluated F-scale questionnaire for Gerd symptoms, and the spinal sagittal alignment and the number of vertebrae fractures by X-ray in a standing position. We calculated the prevalence of Gerd symptoms or spinal sagittal malalignment, and also elucidated the correlation between the scores for F scale and spinal sagittal alignment. Gerd symptoms were observed in 55 cases (40.1%), and sagittal malalignment was observed in 113 cases (82.4%). The prevalence of Gerd symptoms in patients with spinal malalignment (44.2%) was significantly higher than that in patients without spinal malalignment (20.8%). However, we could not detect any correlations between F scale and spinal sagittal alignment. These findings indicated there were many osteoporosis patients with Gerd symptoms or spinal sagittal malalignment. Spinal sagittal malalignment in osteoporosis patients might affect the incidence of Gerd symptoms.
We describe comparative examination of operation results of Hansson pin® (H group) and Twins® (T group) for femoral neck fracture. For the displaced type, Garden alignment index (GAI) decreased in the H group, and the bone union rate fell by correction loss after the operation. In the T group could maintain an angular stability and GAI was little change after the operation, and the bone union rate was good compared with the H group. We could think the implanting choice from which an angular stability is obtained in the displaced type.
Body posture and arm dominance would change the shoulder muscle activation and the range of motion. But those altered shoulder kinematics have not been objectively assessed. The purpose of this study is to evaluate the influence between the standing and supine postures on bilateral shoulder kinematics during arm elevation. Scapular plane humeral elevation in 16 healthy volunteers, eight males and eight females (mean age, 33; range, 19-47) was analyzed using 3D model-image registration methods. Humeral head position relative to glenoid, acromiohumeral distance and scapular rotations were measured and compared between postures. Besides, the effect of arm dominance also was statistically evaluated. Humeral head position relative to glenoid had a significant difference, but acromiohumeral distance did not, between postures. Scapular rotations also were way different between postures. Especially, increasing pattern of upward rotation in supine seemed not to reflect scapulohumeral rhythm which would show almost linear increment. Asymmetries between dominant and non-dominant shoulders had small but significant differences. But the discrepancy tended to be decreased in supine. The change of gravity, scapular orientation and muscle activity might have contributed these results between postures. Our findings indicate that kinematic comparison between postures might be useful to develop diagnostic insight and physical treatment.
It has been reported that bone and muscle mass decrease with age. In the current study, we elucidated the characteristics of primary osteoporosis patients with decreasing muscle mass called as sarcopenia. One hundred and sixteen primary osteoporosis women patients over 65 years of age were included. We reviewed skeletal muscle mass index measured by bioelectrical impedance analysis, bone mineral density (BMD), the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) as low back pain score, SF-36 score as health-related quality of life (QoL) score, and the serum lever of albumin, lymphocyte count, and total cholesterol as nutrition status. We defined less than 5.7 kg/m2 of skeletal muscle mass index as sarcopenia. As the results, 32 patients (27.6%) were defined as sarcopenia in the current study. BMD on femoral neck and the serum level of albumin and lymphocyte count in sarcopenia group were significantly lower than those in non-sarcopenia group. Further, gait disturbance and psychological disorder scores of JOABPEQ and vitality, social function, and mental health scores of SF-36 in sarcopenia group were significantly worse than those in non-sarcopenia group. These findings indicated that sarcopenia patients might have low BMD of femoral neck, low nutrition status, low back pain score, and low health-related QoL.