The impact of spinal surgery on the locomotive syndrome in patients with lumbar spinal stenosis in CDL stage 3: a retrospective study

Abstract

Objectives Locomotive 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 cause 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 CDL stage in patients with LSS. Design A retrospective study Setting The study was conducted at the Department of Orthopaedic Surgery at University Hospital. Participants A total of 157 patients aged 65 and over with LSS underwent lumbar surgery. Interventions: 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 CDL stage following lumbarsurgery were included in the improvement group. Differences in lower-limb pain intensity between the groups were evaluated using the Wilcoxon rank-sum test. Spearman rank correlation coefficient was used to determine correlations between delta lower limb pain and delta GLFS-25. Logistic regression analysis was used to identify factors associated with improvement in LS. Results: The proportion of patients with improved CDL stage was 45.1% (improvement/non-improvement: 32/39). delta Lower limb pain was significantly reduced in the improvement group compared to that in the non-improvement group (51.0 [36.3-71.0] vs 40.0 [4.0-53.5]; p =0.0107). delta GLFS-25 significantly correlated with delta lower-limb pain (r =0.3774, p =0.0031). In a multiple logistic regression analysis, TUG and age were significantly associated with improvement in LS (odds ratio, 1.22; 95% confidence interval: 1.07-1.47). Conclusions: The lumbar surgery effectively improved the CDL stage in patients with LSS. In addition, TUG was an independent factor associated with improvement in the CDL.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study was conducted in accordance with the Herkinsi Declaration and was approved by the Ethics Committee of Kurume University (Approval ID:22025)

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

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Data Availability

Hashida, Ryuki, 2022, The impact of spinal surgery on the locomotive syndrome in patients with lumbar spinal stenosis, https://doi.org/10.7910/DVN/QPA7XO, Harvard Dataverse, DRAFT VERSION

https://doi.org/10.7910/DVN/QPA7XO

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