David Koch (Basel / CH), Dr. Corina Nüesch (Basel / CH), Dr. Dominika Ignasiak (Zürich / CH), Prof. Dr. Stefan Schären (Basel / CH), Prof. Annegret Mündermann (Basel / CH), Prof. Stephen Ferguson (Zürich / CH), PD Dr. Cordula Netzer (Basel / CH)
Abstract-Text (inkl. Referenzen und Bildunterschriften)
Introduction
Spinopelvic alignment has been associated with paraspinal muscle quality1 and paraspinal muscle endurance (PME) in trunk extension2 in patients with symptomatic lumbar spinal stenosis (sLSS).
Aim
To examine the associations between spinopelvic balance, PME as assessed in a modified Biering-Sørensen (BS) test (Roman chair; 45° incline) and self-reported kinesiophobia in patients with sLSS scheduled for decompression surgery.
Methods
Thirty-seven patients with sLSS (25M/12F; age, 69±9 years; BMI, 25.6±4.4 kg/m2) were assessed by biplanar whole-body radiography, performed a modified BS test and completed the Tampa questionnaire3. Pelvic tilt (PT), pelvic incidence (PI) and sacral slope (SS) were extracted from the radiographs. PME was assessed as the duration of the BS test. Pearson correlation was used to investigate the associations between parameters. Forward stepwise linear regression analysis was performed with PME as dependent and PT, PI, SS, BMI, and Tampa score as independent parameters.
Results
PME was significantly associated with PT (R=-0.508, P<0.001) and BMI (R=-0.499, P=0.002). There were no correlations between PME, PI and SS. Stepwise linear regression revealed that BMI explained 33% of the variance of paraspinal muscle endurance (R=0.573, P<0.001). Inclusion of PT and Tampa score increased the explained variance to 60% (R=0.777, P<0.001) and 69% (R=0.830, P=0.011), respectively.
Conclusion
Our results confirm pervious reports2 regarding associations between spinopelvic alignment and PME in patients with sLSS. BMI, PT, and the Tampa Score are important factors for muscle endurance in the BS test. The reasons for the importance of PT in PME are unclear and may include stenosis, shortened muscles, rigidity, and/or pain. Understanding these factors is important for developing improved treatment regimen.
Funding: SNF 204461
1 Zhang et al. 2021 N Am Spine Soc J 2 Han et al. 2022 J Orthop Translat 3 Miller et al. 1991 Clin J Pain