2024 Volume 15 Issue 6 Pages 914-922
Introduction: Locomotive syndrome (LS) is a condition of reduced mobility associated with locomotor disorders, and one of the most common causes is lumbar spinal stenosis (LSS). LS stage 3 is the most severe condition requiring treatment, but there are few reports of the effectiveness of surgery for LS stage 3 and factors related to improving LS stage. This study examined surgical outcomes, including locomotor functions, in patients with LS stage 3 preoperatively. Factors related to improving LS stage were also examined from multiple perspectives, including preoperative locomotor functions, frailty, sarcopenia, and nutritional indices.
Methods: Clinical data of 118 consecutive patients with LS stage 3 preoperatively who underwent surgery for LSS at our institute were prospectively collected. Whether the LS stage and motor function improved at 1 year postoperatively was examined, and the patients were further divided into two groups according to whether theire LS stage improved at 1 year postoperatively, and the preoperative factors that hinder LS stage improvement were evaluated by univariate and multivariate analyses.
Results: At one year postoperatively, JOABPEQ and locomotor functions such as trunk muscle strength and walking speed improved significantly, and 64 patients (54%) showed improvement in their LS stage. Multivariate analysis showed that the factors hindering LS improvement after LSS surgery were preoperative short one-leg standing time and slow gait speed (< 1 m/s), cauda equina type disability, and history of lumbar spine surgery.
Conclusion: Preoperative factors hindering LS improvement after LSS surgery, in patients with LS stage 3 preoperatively, were preoperative short one-leg standing time and slow gait speed (< 1 m/s), cauda equina type disability, and history of lumbar spine surgery.
