Abstract：
Sarcopenia, generally defined by the loss of skeletal mass and function, may disproportionately affect elderly individuals and heavily influence spinal disease. Muscle atrophy is associated with myriad clinical problems, including thoracic kyphosis, increased sagittal vertical axis (SVA), spinal implant failures, and postoperative complications. As such, the aim of this narrative review is to synthesize pertinent literature detailing the intersection between sarcopenia and the impact of sarcopenia on the management of spine disease. Specifically, we focus on the domains of etiology, diagnosis and assessment, impact on the cervical and lumbar spine, spinal augmentation procedures, neoplastic disease, whiplash injury, and recovery/prevention. A narrative review was conducted by searching the PubMed and Google Scholar databases from inception to July 12, 2024, for any cohort studies, systematic reviews, or randomized controlled trials. Case studies and conference abstracts were excluded. Diagnosis of sarcopenia relies on the assessment of muscle strength and quantity/quality. Strength may be assessed using clinical tools such as gait speed, timed up and go (TUG) test, or hand grip strength, whereas muscle quantity/quality may be assessed via computed tomography (CT scan), magnetic resonance imaging (MRI), and dual-energy X-ray absorptiometry (DXA scan). Sarcopenia has a generally negative impact on the clinical course of those undergoing cervical and lumbar surgery, and may be predictive of mortality in those with neoplastic spinal disease. In addition, severe acceleration-deceleration (whiplash) injuries may result in cervical extensor muscle atrophy. Intervention and recovery measures include nutrition or exercise therapy, although the evidence for nutritional intervention is lacking. Sarcopenia is a widely prevalent pathology in the advanced-age population, in which the diagnostic criteria, impact on spinal pathology, and recovery/prevention measures remain understudied. However, further understanding of this therapeutically challenging pathology is paramount, as surgical outcome may be heavily influenced by sarcopenia status.
摘要：
肌肉减少症,通常定义为骨骼质量和功能的丧失，可能不成比例地影响老年人，严重影响脊柱疾病。肌肉萎缩与无数临床问题有关，包括胸椎后凸,增加矢状垂直轴（SVA），脊柱植入失败,术后并发症。因此，这篇叙述性综述的目的是综合相关文献，详述肌肉减少症与肌肉减少症对脊柱疾病治疗的影响之间的交叉关系。具体来说,我们专注于病因学领域，诊断和评估，对颈椎和腰椎的影响，脊柱增强手术,肿瘤疾病，鞭打伤,恢复/预防。从开始到2024年7月12日，通过搜索PubMed和GoogleScholar数据库进行了叙述性审查，以进行任何队列研究，系统评价,或随机对照试验。案例研究和会议摘要被排除在外。肌肉减少症的诊断依赖于肌肉力量和数量/质量的评估。力量可以使用临床工具评估，如步态速度，定时和去（TUG）测试，或握力，而肌肉数量/质量可以通过计算机断层扫描（CT扫描）进行评估，磁共振成像（MRI），和双能X射线吸收法（DXA扫描）。肌肉减少症通常会对接受颈椎和腰椎手术的患者的临床过程产生负面影响，并可能预测肿瘤脊柱疾病患者的死亡率。此外,严重的加速减速（鞭打）损伤可能导致颈伸肌萎缩。干预和恢复措施包括营养或运动治疗，尽管缺乏营养干预的证据。肌肉减少症是高龄人群中广泛流行的病理，其中诊断标准，对脊柱病理学的影响，恢复/预防措施仍未得到充分研究。然而,进一步了解这种具有治疗挑战性的病理学至关重要，因为手术结果可能受到肌肉减少症状态的严重影响。
