Lumbar spinal canal stenosis leads to locomotive syndrome in elderly patients
Lumbar spinal canal stenosis leads to locomotive syndrome in elderly patients
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DOI：
10.1016/j.jos.2018.08.004
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发表时间：
2019-01-01
影响因子：
1.7
通讯作者：
Watanabe, Kota
中科院分区：
文献类型：
--
作者：
Fujita, Nobuyuki;Sakurai, Aiko;Watanabe, Kota
背景资料：机车综合征是一种由于肌肉骨骼系统的一个或多个部分功能障碍而导致正常生活能力受到限制的疾病。尽管腰椎管狭窄症（LSS）被认为是导致机车综合征的原因，但尚未报道对两种病理之间关联的详细评估。方法：前瞻性收集2016年4月至2017年8月期间在多家机构计划接受LSS手术的65岁以上患者的临床数据。共有200名参与者（包括120名男性和80名女性）入组本研究。协会的严重程度评估的LSS的苏黎世跛行问卷评分与三个机车综合征的风险测试（站立测试，两步测试，和25个问题的风险评估）和定时上升和去Test.Results：在总的评估机车综合征，96.5%的参与者被诊断为2级，其余3.5%被诊断为1级。当参与者根据LSS的严重程度分为3组时，所有运动综合征风险测试的分数都随着LSS严重程度的增加而显着下降。Logistic回归分析显示，LSS的严重程度与两步检验评估的运动综合征危险程度呈正相关（OR = 3.45，CI = 1.33-8.96）。此外，我们的研究结果表明，LSS的严重程度可能与运动综合征的进展。LSS的治疗可能有助于减轻运动综合征的风险。(C)2018年日本骨科协会。Elsevier B. V.出版，保留所有权利。
Background: Locomotive syndrome is a condition in which the ability to lead a normal life is restricted owing to a dysfunction in one or more of the parts of the musculoskeletal system. Although lumbar spinal canal stenosis (LSS) is considered to cause locomotive syndrome, a detailed assessment of the association between two pathologies has not yet been reported.Methods: The clinical data of patients aged > 65 years old who planned to undergo surgery for LSS at multiple institutions were prospectively collected from April 2016 to August 2017. A total of 200 participants comprising 120 men and 80 women were enrolled in this study. Association of severity of LSS evaluated by Zurich Claudication Questionnaire scores with three locomotive syndrome risk tests (Stand-up Test, the Two-step Test, and a 25-question risk assessment) and Timed Up-and-Go Test were evaluated.Results: In the total assessment of locomotive syndrome, 96.5% of the participants were diagnosed as grade 2, and the remaining 3.5% were diagnosed as grade 1. When the participants were divided into 3 groups according to the LSS severity, the scores of all locomotive syndrome risk tests were significantly worse with increasing LSS severity. Logistic regression analysis revealed that LSS severity was positively correlated with the risk level of locomotive syndrome evaluated by the Two-step Test (OR = 3.45, CI = 1.33-8.96).Conclusions: All LSS patients with surgical indications were diagnosed as having locomotive syndrome. In addition, our results indicated that LSS severity is potentially associated with the progression of locomotive syndrome. The treatment of LSS may be beneficial in alleviating the risk for locomotive syndrome. (C) 2018 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.