Lumbar spinal surgery improves locomotive syndrome in elderly patients with lumbar spinal canal stenosis

A multicenter prospective study

Nobuyuki Fujita, Takehiro Michikawa, Azusa Miyamoto, Aiko Sakurai, Yohei Otaka, Satoshi Suzuki, Osahiko Tsuji, Narihito Nagoshi, Eijiro Okada, Mitsuru Yagi, Takashi Tsuji, Hitoshi Kono, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe

Research output: Contribution to journalArticle

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
JournalJournal of Orthopaedic Science
DOIs
Publication statusPublished - 01-01-2019

Fingerprint

Spinal Stenosis
Spinal Canal
Multicenter Studies
Prospective Studies
Exercise Test
Failed Back Surgery Syndrome
Logistic Models
Odds Ratio
Confidence Intervals
Nursing Care

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Fujita, Nobuyuki ; Michikawa, Takehiro ; Miyamoto, Azusa ; Sakurai, Aiko ; Otaka, Yohei ; Suzuki, Satoshi ; Tsuji, Osahiko ; Nagoshi, Narihito ; Okada, Eijiro ; Yagi, Mitsuru ; Tsuji, Takashi ; Kono, Hitoshi ; Ishii, Ken ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota. / Lumbar spinal surgery improves locomotive syndrome in elderly patients with lumbar spinal canal stenosis : A multicenter prospective study. In: Journal of Orthopaedic Science. 2019.
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title = "Lumbar spinal surgery improves locomotive syndrome in elderly patients with lumbar spinal canal stenosis: A multicenter prospective study",
abstract = "Background: 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. Methods: 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. Results: 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. Conclusions: 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.",
author = "Nobuyuki Fujita and Takehiro Michikawa and Azusa Miyamoto and Aiko Sakurai and Yohei Otaka and Satoshi Suzuki and Osahiko Tsuji and Narihito Nagoshi and Eijiro Okada and Mitsuru Yagi and Takashi Tsuji and Hitoshi Kono and Ken Ishii and Masaya Nakamura and Morio Matsumoto and Kota Watanabe",
year = "2019",
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Fujita, N, Michikawa, T, Miyamoto, A, Sakurai, A, Otaka, Y, Suzuki, S, Tsuji, O, Nagoshi, N, Okada, E, Yagi, M, Tsuji, T, Kono, H, Ishii, K, Nakamura, M, Matsumoto, M & Watanabe, K 2019, 'Lumbar spinal surgery improves locomotive syndrome in elderly patients with lumbar spinal canal stenosis: A multicenter prospective study', Journal of Orthopaedic Science. https://doi.org/10.1016/j.jos.2019.03.017

Lumbar spinal surgery improves locomotive syndrome in elderly patients with lumbar spinal canal stenosis : A multicenter prospective study. / Fujita, Nobuyuki; Michikawa, Takehiro; Miyamoto, Azusa; Sakurai, Aiko; Otaka, Yohei; Suzuki, Satoshi; Tsuji, Osahiko; Nagoshi, Narihito; Okada, Eijiro; Yagi, Mitsuru; Tsuji, Takashi; Kono, Hitoshi; Ishii, Ken; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota.

In: Journal of Orthopaedic Science, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Lumbar spinal surgery improves locomotive syndrome in elderly patients with lumbar spinal canal stenosis

T2 - A multicenter prospective study

AU - Fujita, Nobuyuki

AU - Michikawa, Takehiro

AU - Miyamoto, Azusa

AU - Sakurai, Aiko

AU - Otaka, Yohei

AU - Suzuki, Satoshi

AU - Tsuji, Osahiko

AU - Nagoshi, Narihito

AU - Okada, Eijiro

AU - Yagi, Mitsuru

AU - Tsuji, Takashi

AU - Kono, Hitoshi

AU - Ishii, Ken

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Kota

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: 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. Methods: 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. Results: 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. Conclusions: 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.

AB - Background: 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. Methods: 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. Results: 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. Conclusions: 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.

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