Muscle Loss Plus Excess Fat Ties to Worse Spine Changes

Muscle loss does not have to occur alone. It can appear alongside excess body fat, creating sarcopenic obesity. Population aging and the obesity epidemic have made this combination a major public health concern. For people with degenerative lumbar spinal stenosis, though, its links with symptoms and spine changes were not well understood.

A retrospective cross-sectional study examined 408 patients with this condition. Every patient was at least 50 years old. The team identified sarcopenic obesity using the ESPEN and EASO consensus criteria, which combine handgrip strength, lean mass in the arms and legs, and fat mass percentage. Patient reports included VAS and ODI scores. Detailed lumbar images were also reviewed for disc, facet joint, spinal canal, and paraspinal muscle changes. Regression analysis tested whether sarcopenic obesity had an independent link with these findings. Moderation analysis then checked whether body fat percentage changed the relationship between sarcopenia and the clinical measures.

Sixty-six patients met the criteria for sarcopenic obesity. After confounding factors were adjusted, the condition was linked to greater functional limitation on the ODI (β = 7.350, P = 0.010). It was also associated with worse intervertebral disc degeneration on the Pfirrmann scale (OR = 5.025, P < 0.001), foraminal stenosis on the Lee scale (OR = 5.495, P < 0.001), a higher prevalence of Modic change (OR = 2.981, P < 0.001), and greater fat infiltration in the erector spinae (ESFI%, β = 2.658, P = 0.001).

Body fat percentage intensified the harmful links involving sarcopenia. It strengthened the association with disc degeneration (OR = 1.254, P = 0.001) and foraminal stenosis (OR = 1.127, P = 0.027). These results support routine screening for sarcopenic obesity during preoperative assessment.