Impact of spinal surgery on locomotive syndrome in patients with lumbar spinal stenosis in clinical decision limit stage 3: a retrospective study

BMC Musculoskeletal Disorders

Research

Kimiaki Yokosuka¹  Takahiro Shimazaki¹  Kimiaki Sato¹  Tatsuhiro Yoshida¹  Takuma Fudo¹  Ichiro Nakae¹  Kei Yamada¹  Shinji Morito¹  Koji Hiraoka¹  Ryuki Hashida²  Hiroo Matsuse²  Sohei Iwanaga²  Naoto Shiba²  Ryota Otsubo³ 

[1] Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, 830-0011, Kurume, Fukuoka, Japan;Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-Machi, 830-0011, Kurume, Fukuoka, Japan;Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, 830-0011, Kurume, Fukuoka, Japan;Division of Rehabilitation, Kurume University Hospital, 67 Asahi-Machi, 830-0011, Kurume, Fukuoka, Japan;

关键词: Lumbar spinal canal stenosis;    Locomotive syndrome;    Low back pain;    Visual analog scale;   

DOI  :  10.1186/s12891-023-06966-x

 received in 2023-06-19, accepted in 2023-10-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLocomotive syndrome (LS) is characterized by reduced mobility. Clinical decision limit (CDL) stage 3 in LS indicates physical frailty. Lumbar spinal canal stenosis (LSS) is one of the causes of LS, for which lumbar surgery is considered to improve the CDL stage. This study aimed to investigate the efficacy of lumbar surgery and independent factors for improving the CDL stage in patients with LSS.MethodsThis retrospective study was conducted at the Department of Orthopaedic Surgery at our University Hospital. A total of 157 patients aged ≥ 65 years with LSS underwent lumbar surgery. The 25-Question Geriatric Locomotive Function scale (GLFS-25) was used to test for LS, and the Timed Up and Go test (TUG) was used to evaluate functional ability. Lower limb pain was evaluated using a visual analog scale. Patients with at least one improvement in the CDL stage following lumbar surgery were included in the improvement group. Differences in lower limb pain intensity between the groups were evaluated using the Wilcoxon rank-sum test. The Spearman’s rank correlation coefficient was used to determine correlations between Δ lower limb pain and Δ GLFS-25. Logistic regression analysis was used to identify factors associated with improvement in LS.ResultsThe proportion of patients with improved CDL stage was 45.1% (improvement/non-improvement: 32/39). Δ Lower limb pain was significantly reduced in the improvement group compared with that in the non-improvement group (51.0 [36.3–71.0] vs 40.0 [4.0–53.5]; p = 0.0107). Δ GLFS-25 was significantly correlated with Δ lower limb pain (r = 0.3774, p = 0.0031). Multiple logistic regression analysis revealed that TUG and age were significantly associated with improvement in LS (odds ratio, 1.22; 95% confidence interval: 1.07–1.47).ConclusionsLumbar surgery effectively improved the CDL stage in patients with LSS. In addition, TUG was an independent factor associated with improvement in the CDL.

【 授权许可】

CC BY   
© The Author(s) 2023

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