Association between preoperative low muscle mass and psychological factors after surgery among patients with lumbar spinal stenosis: A longitudinal study

Abstract Background Patients with lumbar spinal stenosis (LSS) may be at high risk of falls due to various factors. No effective fall risk assessments or fall prevention measures have been performed for patients with LSS because only a few studies have evaluated falls in these patients. This study aimed to evaluate the incidence and preoperative predictors of falls within 12 months of surgery in patients with LSS. Methods In this prospective study of 82 consecutive preoperative patients with LSS, preoperative demographic data, previous fall history, leg pain, low back pain, Japanese Orthopaedic Association (JOA) score, Hospital Anxiety and Depression Scale (HADS) scores, lower extremity muscle strength, walking speed, grip strength, and muscle mass were assessed at baseline. Falls were assessed at 3, 6, 9, and 12 months after surgery. Participants were categorized as fallers and non-fallers and baseline variables were compared. Binomial logistic regression was used to identify predictors of falls within 12 months of surgery. Results Seventy-four patients (90.2%) completed the 12-month follow-up after surgery, of whom 24 patients (32.4%) experienced falls. A higher proportion of fallers were female and had a history of falls compared to non-fallers. Fallers had a significantly lower JOA score and a higher HADS-depression score compared to non-fallers. Fallers had significantly lower tibialis anterior muscle strength, gait speed, grip strength, and skeletal muscle mass index. Fallers had a higher prevalence of low muscle mass compared with non-fallers. The presence of low muscle mass was significantly predictive of falls within 12 months of surgery (odds ratio, 4.46; 95% confidence interval, 1.02–19.63). Conclusions Patients with LSS have a high incidence of falls after surgery and preoperative low muscle mass may be a predictor of postoperative falls.

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Preoperative psychological factors affecting surgical satisfaction of elderly patients with lumbar spinal stenosis

Journal of Orthopaedic Science ◽

10.1016/j.jos.2019.10.005 ◽

2020 ◽

Vol 25 (5) ◽

pp. 751-756 ◽

Cited By ~ 2

Author(s):

Tomoko Kitano CP ◽

Mamoru Kawakami ◽

Daisuke Fukui ◽

Yuyu Ishimoto ◽

Keiji Nagata ◽

...

Keyword(s):

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Psychological Factors ◽

Factors Affecting ◽

Lumbar Spinal

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Surgical results in older patients with lumbar spinal stenosis according to gait speed in relation to the diagnosis for sarcopenia

Journal of Orthopaedic Surgery ◽

10.1177/2309499020918422 ◽

2020 ◽

Vol 28 (2) ◽

pp. 230949902091842

Author(s):

Yoshihito Sakai ◽

Norimitsu Wakao ◽

Hiroki Matsui ◽

Keisuke Tomita ◽

Tsuyoshi Watanabe ◽

...

Keyword(s):

Muscle Mass ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Gait Speed ◽

Daily Living ◽

Older Patients ◽

Surgical Results ◽

Neurologic Disorder ◽

Before And After ◽

Lumbar Spinal

Purpose: The purpose of this study was to evaluate the implication of gait speed, which is a prerequisite for the diagnosis of sarcopenia in older patients with lumbar spinal stenosis (LSS). Methods: This study was conducted in a total of 235 patients with LSS who underwent surgical treatment. The state of sarcopenia and pre-sarcopenia, including gait speed, were evaluated before and after the operation. Results: The proportion of patients with lower than at baseline levels of skeletal muscle mass index (SMI) and gait speed was 27.2% and 17.9%, respectively. Significant changes were observed in gait speed, whereas SMI showed no significant differences between the preoperative and postoperative periods. Sarcopenic patients presented lower levels of activities of daily living preoperatively than pre-sarcopenic patients. However, favorable surgical results were obtained postoperatively. Significant changes were observed in gait speed, whereas grip strength and SMI showed no significant differences between the preoperative and postoperative periods. The postoperative decrease in SMI was not significant. Conclusion: Postoperative gait speed was significantly improved, whereas muscle mass did not increase in the patients in this study. Therefore, low gait speed in patients with LSS seems to be derived from a neurologic disorder. The surgical results in low muscle mass patients without low gait speed were similar to those with low gait speed. Sarcopenia in elderly patients with locomotor disease should be evaluated using muscle mass alone without assessing physical performance.

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Physical and Psychological Factors Associated With Walking Capacity in Patients With Lumbar Spinal Stenosis With Neurogenic Claudication: A Systematic Scoping Review

Frontiers in Neurology ◽

10.3389/fneur.2021.720662 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mariève Houle ◽

Jean-Daniel Bonneau ◽

Andrée-Anne Marchand ◽

Martin Descarreaux

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Scoping Review ◽

Psychological Factors ◽

Gait Pattern ◽

Neurogenic Claudication ◽

Cross Sectional ◽

Factors Associated ◽

Walking Capacity ◽

Lumbar Spinal

Objective: The purpose of this study was to evaluate the current state of scientific knowledge regarding physical and psychological factors associated with walking capacity in patients with lumbar spinal stenosis (LSS) with neurogenic claudication.Design: Systematic scoping review.Literature Search: We searched CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, Cochrane, PsycINFO, and SPORTDiscus databases.Study Selection Criteria: Cohorts and cross-sectional studies reporting on associations between physical or psychological factors and impaired walking capacity in patients with symptomatic LSS were included.Data Synthesis: Data were synthetized to identify associations between physical or psychological factors and either walking capacity, gait pattern characteristics, or functional tasks.Results: Twenty-four studies were included. Walking capacity was significantly correlated with several pain outcomes, disability, estimated walking distance, and cross-sectional area of the lumbar spine. Gait pattern characteristics such as speed and stride were strongly and positively correlated with disability outcomes. Functional tasks were significantly correlated with lower back and upper limb disability, lower limb endurance strength, ranges of motion, and speed. Associations with psychological factors were mostly conflicting except for the Rasch-based Depression Screener and the Pain Anxiety Symptom Scale (PASS-20) questionnaire that were associated with a decreased performance in functional tasks.Conclusion: Physical and psychological factors that are associated with walking capacity in patients with symptomatic LSS were identified. However, many associations reported between physical or psychological factors and walking capacity were conflicting, even more so when correlated with walking capacity specifically.

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