2024-03-29T08:21:54Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00029319
2023-01-16T04:22:26Z
499:500:501
Predictors of walking ability after surgery for lumbar spinal canal stenosis: a prospective study
Takenaka, Hiroto
Sugiura, Hideshi
Kamiya, Mitsuhiro
Nishihama, Kasuri
Ito, Atsuki
Suzuki, Junya
Kawamura, Morio
Hanamura, Shuntaro
Hanamura, Hirokatsu
open access
© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Decompression
Lumbar fusion
Lumbar spinal canal stenosis
Prognostic indicator
Walking ability
6-minute walk distance
BACKGROUND CONTEXT: Few studies have investigated predictors of objective walking distance in patients with lumbar spinal stenosis (LSS). PURPOSE: This study aimed to clarify objective predictors of postoperative 6-minute walk distance (6MWD) in patients with LSS and to develop prediction equations. STUDY DESIGN: This was a prospective study. Data were analyzed by multiple linear regression analyses. PATIENT SAMPLE: Patients with LSS were enrolled. OUTCOME MEASURES: Predictors of 6MWD after surgery were evaluated, including patient characteristics (sex, age, height, and body weight), pain (visual analog scale; low back pain, lower limb pain, and lower limb numbness), surgical factors (number of operation segments [1 or ≥2], surgery type [fusion or decompression], and minimum area of the dural sac), and objective physical function (6MWD and trunk muscle strength). METHODS: Patients with LSS were consecutively included and assessed preoperatively (n=113) and 6 months postoperatively (n=78). Simple and multiple linear regression analyses were performed with 6MWD at 6 months postoperation as the dependent variable. We have study funding sources (Nagono Medical Foundation) and no study-specific conflicts of interest-associated biases. RESULTS: At 6-month follow-up, 6MWD (457.7±105.5 m) improved significantly compared with preoperative 6MWD (275.0±157.2 m; p<.01). Trunk muscle strength and pain improved significantly compared with the preoperative score (p<.01). The predictors of postoperative 6MWD were age, body weight, number of operation segments (1 or ≥2), surgery type (fusion or decompression), preoperative trunk extensor strength, and preoperative 6MWD (adjusted R^2=0.65, p<.01). The proposed prediction equation was as follows: postoperative 6MWD (m)=549.5−5.3×age (years)−1.8×body weight (kg)−68.3×surgery type (0: decompression, 1: fusion)−58.6×operation segment (0: one segment, 1: ≥2 segments)+3.5×trunk extensor strength (kg)+0.2×preoperative 6MWD (m). CONCLUSIONS: Younger age, lower body weight, one level operative segment, decompression surgery, and better preoperative scores for trunk extensor strength and 6MWD predicted better scores for 6 months postoperative 6MWD. Preoperative reduction in body weight and increase of trunk extensor strength might be associated with improved postoperative 6MWD scores.
ファイル公開:2020-11-01
Elsevier
2019-11
eng
journal article
AM
http://hdl.handle.net/2237/00031506
https://nagoya.repo.nii.ac.jp/records/29319
https://doi.org/10.1016/j.spinee.2019.07.002
1529-9430
The Spine Journal
19
11
1824
1831
https://nagoya.repo.nii.ac.jp/record/29319/files/SPINEE-D-19-00140_R2.pdf
application/pdf
462.9 kB
2020-11-01