Ann Rehabil Med.  2015 Feb;39(1):100-107. 10.5535/arm.2015.39.1.100.

Correlates of Bone Mineral Density and Sagittal Spinal Balance in the Aged

• Cho Y
• Lee G
• Aguinaldo
• Lee KJ
• Kim K

• KMID: 2273025
• DOI: http://doi.org/10.5535/arm.2015.39.1.100

Abstract

OBJECTIVE
To investigate the relationship between bone mineral density (BMD) and sagittal spinal balance in the Korean elderly population.
METHODS
The retrospective study included subjects aged 60 years and above, who had whole-spine lateral radiography and dual-energy X-ray absorptiometry (DEXA) within a year's gap between each other. Sagittal vertical axis (SVA) for evaluation of sagittal spinal balance and five spinopelvic parameters were measured through radiography. The presence of compression fracture was identified. Correlations of BMD T-scores with SVA and with the spinopelvic parameters were assessed using Pearson correlation coefficient (PCC). Linear regression analyses were performed between SVA and the clinical and radiologic variables.
RESULTS
One hundred twenty-two subjects (42 males and 80 females; mean age, 69.93+/-5.5 years) were included in the study. BMD, femur or spine, was not correlated with SVA or any spinopelvic parameters in both genders (PCC<+/-0.2), except that spine BMD in men was associated with sacral slope. Univariate regression analysis revealed association between SVA and lumbar lordosis, pelvic tilt, and compression fractures in both genders; it was also associated with age and pelvic incidence in females and with sacral slope in males. Multivariate linear regression model showed lumbar lordosis and compression fracture as variables affecting SVA in both sexes; pelvic incidence was another factor affecting SVA in women only.
CONCLUSION
BMD was not associated with sagittal spinal balance in the aged. Sagittal spinal balance was explained partly by lumbar lordosis and compression fracture. Further study is warranted to understand progression of sagittal imbalance with age.

Keyword

Bone mineral density; Sagittal spinal balance; Spinopelvic parameters

MeSH Terms

Absorptiometry, Photon
Aged
Animals
Axis, Cervical Vertebra
Bone Density*
Female
Femur
Fractures, Compression
Humans
Incidence
Linear Models
Lordosis
Male
Radiography
Retrospective Studies
Spine

Figure

• 

  Fig. 1 (A) Methods of measurement of sagittal vertical axis (SVA) and (A, B) spinopelvic parameters are displayed.

• 

  Fig. 2 The scatter plot shows no correlation between bone mineral density and sagittal vertical axis (SVA) in women (A, B) and men (C, D).

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