Establishment of MRI diagnostic criteria and development of ultrasonic echo evaluation system for the sarcopenia of paraspinal muscle

• Project/Area Number: 21K09306
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56020:Orthopedics-related
• Research Institution: Wakayama Medical University
• Principal Investigator: 橋爪 洋 和歌山県立医科大学, 保健看護学部, 教授 (10326382)
• Co-Investigator(Kenkyū-buntansha): 岡 敬之 東京大学, 医学部附属病院, 特任准教授 (60401064)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Project Status: Granted (Fiscal Year 2022)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2023: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000); Fiscal Year 2022: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2021: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
• Keywords: 傍脊柱筋 / サルコペニア / 腰痛 / 超音波画像 / MRI / 脊柱後弯症 / 超音波エコー / 一般住民 / 脊柱後弯

Outline of Research at the Start

本研究は脊椎加齢変性をターゲットとする大規模一般住民コホート10年目の追跡調査を完遂し、①全脊柱MRI、②全脊柱立位X線側面像、③四肢体幹筋量、④健康関連QOL、⑤身体能力を含む膨大な臨床データベースの縦断的解析により脊柱後弯症の発生ならびに進行を予測可能なMRI上の傍脊柱筋サルコペニアの診断基準を確立することを第一の目的とする。第二の目的は追跡調査時に傍脊柱筋の超音波エコー画像を収集し、独自の解析ソフトで評価した結果をMRIと対比させることで、MRIに代わる簡便な傍脊柱筋評価システム開発の礎を築くことである。研究成果は国民の医療費抑制につながる可能性を有する。

Outline of Annual Research Achievements

令和4年度は和歌山県日高川町において一般住民681名（男性231名、女性450名、平均年齢68.4歳）を対象に運動器検診を実施し、腰椎MRI、腰背筋エコー、全脊X線柱立位側面像、腰痛の有無、腰痛関連ADL障害（Oswestry Disability Index）、体組成、握力、歩行速度、5回椅子立ち上がり時間の評価を実施した。さらに令和5年度は10－12月には和歌山県太地町において一般住民約1000名を対象に令和4年度と同様の運動器検診を計画している。以上により、大規模一般住民コホート10年目の追跡調査を完遂させる。令和5年度の到達目標の第一は1)全脊柱MRI、2)全脊柱立位X線側面像、3)四肢体幹筋量、4)健康関連QOL、5)身体能力を含む膨大な臨床データベースの縦断的解析によりMRI上の傍脊柱 筋サルコペニアの診断基準を確立することである。第二の目標は傍脊柱筋の超音波エコー画像を独自の解析ソフトで評価した結果をMRIと対比させ ることで、MRIに代わる簡便な傍脊柱筋評価システム開発の礎を築くことである。具体的にはMR横断像での脊柱周囲筋脂肪浸潤割合（fatty infiltration ratio）とエコー画像解析結果を対比させその相関を求めるとともに、エコー画像テクスチャー解析によって得られる指標と腰痛、ADL、脊柱アライメント、身体能力との関連を検討する。研究成果 は地域ならびに臨床現場に還元され、将来的に国民の医療費抑制につながる可能性を有するものと考えている。

Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

令和4年度はコロナ禍の下、コホートの追跡対象者に限って運動器検診を実施し、681名のデータ収集を完遂した。令和5年度の運動器検診でも約1000名の参加者を見込んでいる。研究目的に資する解析に十分なサンプルサイズが得られるものと考えている。

Strategy for Future Research Activity

令和5年度はさらサンプル収集を推進すると共に、これまでに得られた臨床情報を基にMR横断像での脊柱周囲筋脂肪浸潤割合（fatty infiltration ratio）とエコー画像解析結果を対比させその相関を求めるとともに、エコー画像テクスチャー解析によって得られる指標と腰痛、ADL、脊柱アライメント、身体能力との関連を検討する。

Research Products

• [Journal Article] Epidemiology of locomotive syndrome using updated clinical decision limits: 6 years follow-ups of the ROAD study (2022)
  • Author(s): Yoshimura N, Iidaka T, Horii C, Mure K, Muraki S. Oka H, Kawaguchi H, Akune T, Ishibashi H, Ohe T, Hashizume H, Yamada H, Yoshida M, Nakamura K, Tanaka S.
  • Journal Title: J Bone Miner Metab Volume: 40 Pages: 623-635
  • DOI: 10.1007/s00774-022-01324-8
  • Peer Reviewed
• [Journal Article] Association between acetabular dysplasia and sagittal spino-pelvic alignment in a population-based cohort in Japan (2022)
  • Author(s): Harada T, Hashizume H, Taniguchi T, Iidaka T, Asai Y, Oka H, Muraki S, Akune T, Kawaguchi H, Nakamura K, Yoshida M, Tanaka S, Yoshimura N, Yamada H.
  • Journal Title: Sci Rep Volume: 12 Issue: 1 Pages: 12686-12686
  • DOI: 10.1038/s41598-022-16865-1
  • Peer Reviewed / Open Access
• [Journal Article] Association between serum insulin-like growth factor 1 and locomotive syndrome in community-dwelling older people (2022)
  • Author(s): 116.Nakamura M, Imaoka M, Nakao H, Hida M, Tazaki F, Imai R, Hashizume H.
  • Journal Title: BMC Musculoskelet Disord Volume: 23 Issue: 1 Pages: 766-766
  • DOI: 10.1186/s12891-022-05738-3
  • Peer Reviewed / Open Access
• [Journal Article] Importance of physiological age in determining indications for adult spinal deformity surgery in patients over 75 years of age: a propensity score matching analysis (2022)
  • Author(s): Importance of physiological age in determining indications for adult spinal deformity surgery in patients over 75 years of age: a propensity score matching analysis
  • Journal Title: Eur Spine J Volume: 31 Issue: 11 Pages: 3060-3068
  • DOI: 10.1007/s00586-022-07379-5
  • Peer Reviewed / Open Access
• [Journal Article] The discrepancy between radiographically-assessed and self-recognized hallux valgus in a large population-based cohort (2022)
  • Author(s): Matsumoto Takumi、Higuchi Junya、Maenohara Yuji、Chang Song Ho、Iidaka Toshiko、Horii Chiaki、Oka Hiroyuki、Muraki Shigeyuki、Hashizume Hiroshi、Yamada Hiroshi、Yoshida Munehito、Nakamura Kozo、Tanaka Sakae、Yoshimura Noriko
  • Journal Title: BMC Musculoskeletal Disorders Volume: 23 Issue: 1 Pages: 31-31
  • DOI: 10.1186/s12891-021-04978-z
  • Peer Reviewed / Open Access
• [Journal Article] A Prospective, 3-year Longitudinal Study of Modic Changes of the Lumbar Spine in a Population-based Cohort: The Wakayama Spine Study (2022)
  • Author(s): Tamai H, Teraguchi M, Hashizume H, Oka H, Cheung JPY, Samartzis D, Muraki S, Akune T, Kawaguchi H, Nakamura K, Tanaka S, Yoshida M, Yoshimura N, Yamada H.
  • Journal Title: Spine Volume: 47 Issue: 6 Pages: 490-497
  • DOI: 10.1097/brs.0000000000004301
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Relationship Between Age-Related Spinopelvic Sagittal Alignment and Low Back Pain in Adults of Population-Based Cohorts: The ROAD Study (2022)
  • Author(s): Asai Yoshiki、Tsutsui Shunji、Yoshimura Noriko、Hashizume Hiroshi、Iidaka Toshiko、Horii Chiaki、Kawaguchi Hiroshi、Nakamura Kozo、Tanaka Sakae、Yoshida Munehito、Yamada Hiroshi
  • Journal Title: Journal of Pain Research Volume: Volume 15 Pages: 33-38
  • DOI: 10.2147/jpr.s339712
  • Peer Reviewed / Open Access
• [Journal Article] Is radiographic lumbar spinal stenosis associated with the quality of life?: The Wakayama Spine Study (2022)
  • Author(s): Arita S, Ishimoto Y, Hashizume H, Nagata K, Muraki S, Oka H, Takami M, Tsutsui S, Iwasaki H, Yukawa Y, Akune T, Kawaguchi H, Tanaka S, Nakamura K, Yoshida M, Yoshimura N, Yamada H
  • Journal Title: PLOS ONE Volume: 17 Issue: 2 Pages: e0263930-e0263930
  • DOI: 10.1371/journal.pone.0263930
  • Peer Reviewed / Open Access
• [Journal Article] Lateral interbody release for fused vertebrae via transpsoas approach in adult spinal deformity surgery: a preliminary report of radiographic and clinical outcomes (2022)
  • Author(s): Takami Masanari、Tsutsui Shunji、Yukawa Yasutsugu、Hashizume Hiroshi、Minamide Akihito、Iwasaki Hiroshi、Nagata Keiji、Taiji Ryo、Schoenfeld Andrew J.、Simpson Andrew K.、Yamada Hiroshi
  • Journal Title: BMC Musculoskeletal Disorders Volume: 23 Issue: 1
  • DOI: 10.1186/s12891-022-05204-0
  • Peer Reviewed / Open Access
• [Journal Article] Kitchen elbow sign predicts surgical outcomes in adults with spinal deformity: a retrospective cohort study (2021)
  • Author(s): Murata Shizumasa、Hashizume Hiroshi、Nagata Keiji、Yukawa Yasutsugu、Minamide Akihito、Iwasaki Hiroshi、Tsutsui Shunji、Takami Masanari、Taiji Ryo、Kozaki Takuhei、Yamada Hiroshi
  • Journal Title: Scientific Reports Volume: 11 Issue: 1
  • DOI: 10.1038/s41598-021-92520-5
  • Peer Reviewed / Open Access
• [Journal Article] Optimal Anchor at the Uppermost Instrumented Vertebra in Long Fusion From the Pelvis to the Lower Thoracic Spine in Elderly Patients With Degenerative Spinal Deformity (2021)
  • Author(s): Tsutsui Shunji、Hashizume Hiroshi、Yukawa Yasutsugu、Minamide Akihito、Nakagawa Yukihiro、Iwasaki Hiroshi、Takami Masanari、Yamada Hiroshi
  • Journal Title: Clinical Spine Surgery: A Spine Publication Volume: 35 Issue: 1 Pages: E280-E284
  • DOI: 10.1097/bsd.0000000000001204
  • Peer Reviewed
• [Journal Article] Association between subjective oral dysfunction and locomotive syndrome in community-dwelling older adults (2021)
  • Author(s): Nakamura Misa、Imaoka Masakazu、Nakao Hidetoshi、Hida Mitsumasa、Tazaki Fumie、Imai Ryota、Utsunomiya Hirotoshi、Hashizume Hiroshi
  • Journal Title: Scientific Reports Volume: 11 Issue: 1
  • DOI: 10.1038/s41598-021-92153-8
  • Peer Reviewed / Open Access
• [Journal Article] Relationship of sagittal spinal alignment with low back pain and physical performance in the general population (2021)
  • Author(s): Hira Kazuhiro、Nagata Keiji、Hashizume Hiroshi、Asai Yoshiki、Oka Hiroyuki、Tsutsui Shunji、Takami Masanari、Iwasaki Hiroshi、Muraki Shigeyuki、Akune Toru、Iidaka Toshiko、Kawaguchi Hiroshi、Nakamura Kozo、Yoshida Munehito、Tanaka Sakae、Yoshimura Noriko、Yamada Hiroshi
  • Journal Title: Scientific Reports Volume: 11 Issue: 1 Pages: 20604-20604
  • DOI: 10.1038/s41598-021-00116-w
  • Peer Reviewed / Open Access
• [Journal Article] The beneficial effect of physical activity on cognitive function in community-dwelling older persons with locomotive syndrome (2021)
  • Author(s): Nakamura Misa、Imaoka Masakazu、Hashizume Hiroshi、Tazaki Fumie、Hida Mitsumasa、Nakao Hidetoshi、Omizu Tomoko、Kanemoto Hideki、Takeda Masatoshi
  • Journal Title: PeerJ Volume: 9 Pages: e12292-e12292
  • DOI: 10.7717/peerj.12292
  • Peer Reviewed / Open Access
• [Journal Article] Improving effect of microendoscopic decompression surgery on low back pain in patients with lumbar spinal stenosis and predictive factors of postoperative residual low back pain: a single-center retrospective study (2021)
  • Author(s): Taiji Ryo、Iwasaki Hiroshi、Hashizume Hiroshi、Yukawa Yasutsugu、Minamide Akihito、Nakagawa Yukihiro、Tsutsui Shunji、Takami Masanari、Nagata Keiji、Murata Shizumasa、Kozaki Takuhei、Yoshida Munehito、Yamada Hiroshi
  • Journal Title: BMC Musculoskeletal Disorders Volume: 22 Issue: 1
  • DOI: 10.1186/s12891-021-04844-y
  • Peer Reviewed / Open Access
• [Journal Article] Detailed Subphenotyping of Lumbar Modic Changes and Their Association with Low Back Pain in a Large Population-Based Study: The Wakayama Spine Study (2021)
  • Author(s): Teraguchi Masatoshi、Hashizume Hiroshi、Oka Hiroyuki、Cheung Jason P. Y.、Samartzis Dino、Tamai Hidenobu、Muraki Shigeyuki、Akune Toru、Tanaka Sakae、Yoshida Munehito、Yoshimura Noriko、Yamada Hiroshi
  • Journal Title: Pain and Therapy Volume: 11 Issue: 1 Pages: 57-71
  • DOI: 10.1007/s40122-021-00337-x
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] The cumulative incidence of and risk factors for morphometric severe vertebral fractures in Japanese men and women: the ROAD study third and fourth surveys (2021)
  • Author(s): Horii C.、Iidaka T.、Muraki S.、Oka H.、Asai Y.、Tsutsui S.、Hashizume H.、Yamada H.、Yoshida M.、Kawaguchi H.、Nakamura K.、Akune T.、Oshima Y.、Tanaka S.、Yoshimura Noriko
  • Journal Title: Osteoporosis International Volume: 33 Issue: 4 Pages: 889-899
  • DOI: 10.1007/s00198-021-06143-7
  • Peer Reviewed
• [Presentation] The Sex and Age Distribution of Indices for Muscle Evaluation and Their Association with Spinal Sagittal Alignment -The Wakayama Spine Study (2022)
  • Author(s): Hiroshi Hashizume
  • Organizer: Back to Back 5-6 April 2022 meeting at St. Annes
  • Int'l Joint Research / Invited
• [Presentation] Associations of spinal images with adult disability -The Wakayama Spine Study (2022)
  • Author(s): Hiroshi Hashizume
  • Organizer: Back to Back 5-6 April 2022 meeting at St. Annes
  • Int'l Joint Research / Invited
• [Presentation] What is most related to spinal malalignment among various muscle evaluation indices? -The Wakayama Spine Study (2022)
  • Author(s): Hiroshi Hashizume
  • Organizer: 48th Annual Meeting of International Society for the Study of Lumbar Spine (ISSLS)
  • Int'l Joint Research
• [Presentation] Prevalence of lumbar scoliosis and its association with clinical symptoms -A large scale general population survey: The Wakayama Spine Study (2022)
  • Author(s): Satoshi Arita, Hiroshi Hashizume, et al.
  • Organizer: 48th Annual Meeting of International Society for the Study of Lumbar Spine (ISSLS)
  • Int'l Joint Research
• [Presentation] シンポジウム54 サルコペニアと腰痛．サルコペニアと脊柱アライメント不良－The Wakayama Spine Study (2022)
  • Author(s): 橋爪洋
  • Organizer: 第95回日本整形外科学会学術総会
  • Invited
• [Presentation] Lumbar disc degeneration and vertebral fracture at thoracolumbar junction are risk factors for chronic low back pain with disability: 7 years’ follow-up of the Wakayama Spine Study (2021)
  • Author(s): Hashizume H
  • Organizer: 47th Annual Meeting of International Society for the Study of Lumbar Spine (ISSLS)
  • Int'l Joint Research
• [Presentation] Theoretical strategy for the perioperative management of low back pain with degenerative lumbar disease -Recommendation from the epidemiological study (2021)
  • Author(s): Hashizume H
  • Organizer: The 21st Annual Meeting of the Pacific and Asian Society of Minimally Invasive Spine Surgery
  • Int'l Joint Research
• [Presentation] MRI上の腰部脊柱管狭窄は地域住民のQOLに影響しない Wakayama Spine Studyの知見より (2021)
  • Author(s): 有田智氏，橋爪洋（共同演者7名中3番目）
  • Organizer: 第58回日本リハビリテーション医学会学術集会
• [Presentation] ADL障害を伴う慢性腰痛のMR画像上危険因子 The Wakayama Spine Study (2021)
  • Author(s): 橋爪洋
  • Organizer: 第94回日本整形外科学会学術総会
• [Presentation] 椎間高の減少は男性よりも女性の臨床症状に影響する The Wakayama Spine Study (2021)
  • Author(s): 石元優々，橋爪洋（共同演者12名中5番目）
  • Organizer: 第50回日本脊椎脊髄病学会学術集会
• [Presentation] 慢性腰痛症の薬物療法を再考する 中枢性感作メカニズムと臨床経験からの考察 (2021)
  • Author(s): 橋爪洋
  • Organizer: 第136回中部日本整形外科災害外科学会学術集会
  • Invited
• [Presentation] 変形関節症と骨粗鬆症 一般住民における腰部脊柱管狭窄症と骨粗鬆症の併存 変形関節症と骨粗鬆症 一般住民における腰部脊柱管狭窄症と骨粗鬆症の併存 The Wakayama Spine Study (2021)
  • Author(s): 橋爪洋
  • Organizer: 第39回日本骨代謝学会学術集会
  • Invited