Full-Body Radiographic Imaging-Based Thigh Muscle Measurement for Sarcopenia

作者：Joseph E. Nassar, Michael Farias, Richard Hostin, Munish C. Gupta, Eric O. Klineberg, Gregory M. Mundis, David O. Okonkwo, Kojo Hamilton, Peter G. Passias, Themistocles S. Protopsaltis, Han Jo Kim, Jeffrey L. Gum, Justin S. Smith, Micheal Raad, Khaled M. Kebaish, Lawrence G. Lenke, Christopher I. Shaffrey, Shay Bess, Frank J. Schwab, Renaud Lafage, Virginie Lafage, Alan H. Daniels, Bassel G. Diebo, on behalf of the International Spine Study Group · 发表于：Spine · 年份：2026 · DOI：10.1097/brs.0000000000005777 · 研究领域：Nutrition and Health in Aging、Scoliosis diagnosis and treatment、Parkinson's Disease and Spinal Disorders

STUDY DESIGN: Multicenter retrospective cohort study of prospectively collected data. OBJECTIVE: Evaluate the impact of EOS-derived thigh muscle measurements as indicators of sarcopenia and their effect on compensatory mechanisms in adult spinal deformity (ASD) patients. SUMMARY OF BACKGROUND DATA: ASD patients frequently present with sarcopenia, the progressive loss of muscle strength and mass associated with worse postoperative outcomes. Routine EOS full-body radiographs allow opportunistic thigh muscle measurement without added cost or radiation. This study evaluated EOS-derived thigh and quadriceps thickness against clinical indicators of sarcopenia and their impact on compensatory mechanisms in ASD. METHODS: We retrospectively analyzed prospectively collected data from 24 U.S. and Canadian spine centers(2019-2024). Sarcopenia was defined using validated sex-specific EOS cutoffs. Patients were classified as sarcopenic only when both AP thigh and LAT quadriceps measurements fell below threshold. Clinical frailty scores, grip strength, 3-meter timed up and go(TUG), and epigenetic age were compared between sarcopenic(SARCO) and non-sarcopenic(NON-SARCO) patients. Multivariate regressions assessed associations between thigh measurements, sarcopenia status, and compensatory radiographic parameters. RESULTS: Among 540 ASD patients (mean age 60, 71% female), 61 (11.3%) were SARCO. SARCO patients had lower BMI(23.6 vs. 27.3 kg/m²), higher clinical frailty scores (3.4 vs. 3.0), an...