Surgical results in older patients with lumbar spinal stenosis according to gait speed in relation to the diagnosis for sarcopenia
Surgical results in older patients with lumbar spinal stenosis according to gait speed in relation to the diagnosis for sarcopenia
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DOI：
10.1177/2309499020918422
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发表时间：
2020-05-01
影响因子：
1.6
通讯作者：
Iida, Hiroki
中科院分区：
文献类型：
--
作者：
Sakai, Yoshihito;Wakao, Norimitsu;Iida, Hiroki
目的：本研究的目的是评估步态速度的意义，步态速度是老年腰椎管狭窄症（LSS）患者肌肉减少症诊断的先决条件。方法：本研究共纳入235例接受手术治疗的LSS患者。评估手术前后肌肉减少症和前期肌肉减少症的状态，包括步态速度。结果：骨骼肌质量指数（SMI）和步态速度低于基线水平的患者比例分别为27.2%和17.9%。步态速度有显著变化，而SMI在术前和术后无显著差异。肌少症患者术前的日常生活活动水平低于肌少症前的患者。然而，术后获得良好的手术效果。在术前和术后期间，步态速度观察到显著变化，而握力和SMI没有显着差异。术后SMI下降不显著。结论：本研究患者术后步态速度明显改善，而肌肉量没有增加。因此，LSS患者的低步态速度似乎源于神经系统疾病。无低步速的低肌量患者的手术效果与低步速患者相似。老年运动疾病患者的肌肉减少症应仅用肌肉质量来评估，而不应评估身体表现。
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.