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Lumbar spinal surgery improves locomotive syndrome in elderly patients with lumbar spinal canal stenosis: A multicenter prospective study.

Authors
  • Fujita, Nobuyuki1
  • Michikawa, Takehiro2
  • Miyamoto, Azusa3
  • Sakurai, Aiko4
  • Otaka, Yohei5
  • Suzuki, Satoshi1
  • Tsuji, Osahiko1
  • Nagoshi, Narihito1
  • Okada, Eijiro1
  • Yagi, Mitsuru1
  • Tsuji, Takashi6
  • Kono, Hitoshi7
  • Ishii, Ken8
  • Nakamura, Masaya1
  • Matsumoto, Morio1
  • Watanabe, Kota9
  • 1 Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan; Keio Spine Research Group (KSRG), Tokyo, Japan. , (Japan)
  • 2 Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan. , (Japan)
  • 3 Keiyu Orthopaedic Hospital, Tatebayashi, Japan. , (Japan)
  • 4 Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan. , (Japan)
  • 5 Department of Rehabilitation Medicine I, Fujita Health University, Aichi, Japan. , (Japan)
  • 6 Department of Orthopaedic Surgery, Fujita Health University, Aichi, Japan; Keio Spine Research Group (KSRG), Tokyo, Japan. , (Japan)
  • 7 Keiyu Orthopaedic Hospital, Tatebayashi, Japan; Keio Spine Research Group (KSRG), Tokyo, Japan. , (Japan)
  • 8 Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan; Keio Spine Research Group (KSRG), Tokyo, Japan. , (Japan)
  • 9 Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan; Keio Spine Research Group (KSRG), Tokyo, Japan. Electronic address: [email protected] , (Japan)
Type
Published Article
Journal
Journal of Orthopaedic Science
Publisher
Elsevier
Publication Date
Mar 01, 2020
Volume
25
Issue
2
Pages
213–218
Identifiers
DOI: 10.1016/j.jos.2019.03.017
PMID: 30982707
Source
Medline
Language
English
License
Unknown

Abstract

Owing to musculoskeletal dysfunction, locomotive syndrome elevates the risk of requiring nursing care. Among degenerative musculoskeletal disorders, lumbar spinal canal stenosis (LSS) associates with locomotive syndrome; however, whether lumbar spinal surgery for LSS improves locomotive syndrome remains unclear. Hence, this study aimed to identify the efficacy of lumbar spinal surgery on locomotive syndrome among elderly patients with LSS. We prospectively collected the clinical data from multiple institutions of patients (age >65 years) who underwent lumbar spinal surgery. Patients were examined for the locomotive syndrome risk test, including the stand-up Test, the two-step Test, and the 25-question risk assessment, 1-day preoperatively and 6-month and 1-year postoperatively. Using a logistic regression model, we identified factors associated with improvement of locomotive syndrome in the total assessment. Overall, we examined the data of 166 patients in this study. Upon converting each score of three tests to the stage of locomotive syndrome, the two-step test and the 25-question risk assessment revealed marked improvement in the postoperative distribution of stages. However, the stand-up test revealed a comparable distribution of stages pre- and postoperatively. In the total assessment, the postoperative distribution of stages was significantly improved than that preoperatively. The multivariable analysis revealed that failed back surgery syndrome [odds ratio (OR), 0.2; 95% confidence interval (CI): 0.04-1.05; P = 0.057)] and preoperative stage of 2 in stand-up test (OR, 0.2; 95% CI: 0.05-1.02; P = 0.054) tended to have inverse association with postoperative improvement of locomotive syndrome in the total assessment. Lumbar spinal surgery improved the stage of locomotive syndrome among elderly patients with LSS. This study suggests that lumbar spinal surgery for LSS could be beneficial in alleviating locomotive syndrome. Copyright © 2019 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

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