Radiographic Measurement of Psoas Muscle Width: A Simple and Reliable Screening Tool for Sarcopenia

Area of Science:

• Orthopaedic Surgery
• Radiology
• Geriatrics

Background:

• Sarcopenia, the loss of muscle mass and strength, increases postoperative complications in orthopaedic patients.
• Computed tomography (CT) and magnetic resonance imaging (MRI) are gold standards for sarcopenia assessment but are costly and less accessible.
• This study explored lumbar spine radiographs as a practical screening tool for sarcopenia.

Purpose of the Study:

• To evaluate the utility of lumbar spine radiographs for sarcopenia screening.
• To compare radiographic psoas muscle width measurements with CT-derived psoas muscle area.
• To establish the reliability and predictive value of radiographic measurements for sarcopenia.

Main Methods:

• Retrospective review of 305 patients undergoing lumbar spine surgery with available radiographs and CT scans.
• Measurement of psoas muscle width on anteroposterior lumbar spine radiographs at the L3 level.
• Comparison with CT-based psoas muscle area, assessing interobserver reliability (ICC) and performing correlation and ROC analyses.

Main Results:

• Radiographic psoas muscle width showed excellent interobserver reliability (ICC=0.94).
• Strong correlations were found between radiographic width and CT-measured area (males r=0.71, females r=0.64).
• Optimal cutoff values for sarcopenia screening were identified: 118.8 mm for males and 99.9 mm for females.

Conclusions:

• Lumbar spine radiography offers a simple, reliable method for sarcopenia screening.
• This approach can facilitate early detection and intervention for sarcopenia.
• Radiographs may serve as a novel screening tool, improving surgical outcome predictions.