Design.: Single-center, cross-sectional study. Objective.: To investigate the correlation between core muscle morphology and pain and disability in DLS patients. Summary of Background Data.: Sarcopenia has been shown to correlate with pain and disability in degenerative lumbar scoliosis (DLS) patients. The role of individual core muscle morphology, including paraspinal, hip, and abdominal muscles, has been poorly understood in their correlation to pain and disability in these patients. Methods.: Ninety-one patients with de novo degenerative lumbar or thoracolumbar scoliosis at a single tertiary hospital with completed clinical questionnaires, whole-spine radiographs, and truncal computed tomography (CT) scans were included. Back pain visual analog scale (back VAS) and leg pain visual analog scale (leg VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) scores were primary outcomes of the study. Relative cross-sectional areas (rCSAs) and intramuscular fatty infiltration ratios (FIR) were calculated for each muscle based on CT scans. Results.: In both univariable and multivariable analyses, gluteus maximus FIR correlated with back VAS ( P =0.022 and 0.045, respectively) and SF-36 PCS ( P =0.005 and 0.023, respectively), while gluteus medius FIR correlated with SF-36 PCS ( P =0.002 and 0.011, respectively). Abdomen and paraspinal muscles did not exhibit any significant relationship with pain and disability scores. Conclusions.: Fatty infiltration of the gluteus maximus and gluteus medius muscles correlated with both back pain and disability in DLS patients. Paraspinal and abdominal muscles did not significantly correlate with pain and disability among DLS patients. The association between hip muscles and worse pain and disability in DLS patients suggests a new anatomic candidate for symptom variation in advanced lumbar pathologies. Level of Evidence.: Level IV.

Links between sagittal spinal alignment and acetabular orientation attract considerable research attention with the goal of understanding “hip-spine syndrome.” However, whether pelvic incidence (PI) is related to acetabular orientation remains debatable. The purpose of the present study was to determine We analyzed 100 abdominopelvic computed tomography (CT) scans of skeletally healthy young adults. We measured PI and acetabular orientation with three-dimensional (3D) measurements. The orientation of 200 acetabula was measured using 3D reconstructed models of 100 pelvises in the coordinate system based on the anterior pelvic plane (APP). To quantify the acetabular orientation, the radiographic definitions of anteversion and inclination were used. To examine the correlation between acetabular orientation and PI, Pearson's correlation was used. The mean PI was 46.9° ± 10.2°, and the mean acetabular orientation 15.3° ± 5.7° anteverted and 37.5° ± 3.9° inclined. While no significant difference in the PI was observed, the average acetabular orientation of female pelvises (anteversion, 17.5° ± 5.6°; inclination, 36.7° ± 3.7°) was more anteverted and less inclined compared to that of male pelvises (anteversion, 13.2° ± 4.9°; inclination, 38.3° ± 3.9°, respectively; P values < .05). The correlation between PI and acetabular orientation was statistically not significant. After division of study group by sex, the linear correlation between PI and acetabular orientation was not statistically supported. The asymmetry of the acetabular orientation between the left and right sides was not significant. The linear relationship between anatomical acetabular orientation and PI was not evident in the normal population. Our finding thus proves the absence of a linear relationship between the upper and lower articular orientation of the pelvic segment and deepens the understanding of the characteristics of acetabular orientation and PI.

(1) Background: Being underweight is a known risk factor for hip fractures. However, it is unclear whether the cumulative underweight burden affects the incidence of hip fractures. Therefore, we explored the effect of the cumulative underweight burden on the development of hip fractures; (2) Methods: In a cohort of adults aged 40 years and older, 561,779 participants who were not underweight and had no hip fractures from 2007 to 2009 were identified. The risk of hip fracture from the time of the last examination to December 2018 according to the cumulative burden of being underweight (based on 0 to 3 examinations) was prospectively analyzed; (3) Results: During follow-up (mean 8.3 ± 0.8 years), the prevalence of newly diagnosed hip fractures was 0.2%, 0.4%, 0.5%, and 0.9% among those with 0, 1, 2, and 3 cumulative underweight, respectively. The adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of groups meeting the diagnostic criteria for underweight 1, 2, and 3 compared to 0 were 2.3 (1.6–3.3), 2.9 (1.8–4.5), and 4.5 (3.4–6.1), respectively (p for trend < 0.01); (4) Conclusions: The risk of hip fracture increased as the burden of underweight accumulated.