• Kazuyuki Watanabe, Koji Otani, Ryoji Tominaga, Yoshiyuki Kokubun, Miho Sekiguchi, Shingo Fukuma, Tsukasa Kamitani, Takuya Nikaido, Kinshi Kato, Hiroshi Kobayashi, Shoji Yabuki, KikuchiShin-IchiSIDepartment of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan., and Shin-Ichi Konno.
• Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan. kazu-w@fmu.ac.jp.
• Eur Spine J. 2021 Sep 1; 30 (9): 2450-2456.

PurposeWith spinal deformities, mental health can deteriorate due to sagittal imbalance of the spine. The purpose of this study was to clarify the relationship between sagittal imbalance and symptoms of depression among local residents in the community.MethodsThis study used data from the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS) in 2010. The sagittal vertical axis (SVA) was identified as an indicator of sagittal imbalance. Symptoms of depression were assessed using the 5-item version of the Mental Health Inventory. Participants were classified into three categories based on the SVA balance as normal (< 40 mm), moderate imbalance (40-95 mm), and severe imbalance (> 95 mm). To evaluate the relationship between sagittal imbalance of the spine and symptoms of depression, the adjusted risk ratio (RR) and the 95% confidence interval (CI) were calculated using a generalized linear model with Poisson link.ResultsThere were 786 participants included in the statistical analysis. Overall, the mean age was 68.1 y (standard deviation, 8.8 y), and 39.4% were men. The prevalence of symptoms of depression by SVA category was 18.6% for normal, 23.8% for moderate, and 40.6% for severe. On multivariate analysis, the RR of SVA for symptoms of depression compared to the normal category was 1.12 (95% CI 0.7-1.70) for the moderate category and 2.29 (95% CI 1.01-5.17) for the severe category.ConclusionIn local community residents, sagittal imbalance had a significant association with symptoms of depression.© 2020. The Author(s).

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