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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Degenerative Disease | Research article

Improvement of locomotive syndrome with surgical treatment in patients with degenerative diseases in the lumbar spine and lower extremities: a prospective cohort study

Authors: Satoshi Kato, Yuki Kurokawa, Tamon Kabata, Satoru Demura, Hidenori Matsubara, Yoshitomo Kajino, Yoshiyuki Okamoto, Hiroaki Kimura, Kazuya Shinmura, Kentaro Igarashi, Takaki Shimizu, Noritaka Yonezawa, Noriaki Yokogawa, Hiroyuki Tsuchiya

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

The epidemiology, risk factors, and prevention of locomotive syndrome (LS) have been reported. However, the number of clinical studies about the efficacy of LS treatment, including surgery, has been limited. This study aimed to evaluate LS and its improvement in patients undergoing surgeries for degenerative disease of the lumbar spine and lower extremities, and to discuss the effects of surgery on LS and the issues of LS assessment in these patients.

Methods

We enrolled 257 patients aged ≥60 years that underwent surgery for degenerative diseases of the lumbar spine and lower extremities and agreed to participate in the preoperative and 6- and 12-month postoperative LS examinations. According to the disease location, patients were divided into the lumbar (n = 81), hip (n = 106), knee (n = 43), and foot and ankle (n = 27) groups. Patients underwent LS risk tests, including the stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale (GLFS-25) assessment.

Results

The preoperative prevalence of LS stage 2 was 95%. Only the hip group showed significant improvements in the stand-up test. The knee group showed the worst results in the stand-up and two-step tests at all time points. All four groups had significant improvements in GLFS-25 scores. Approximately 40% of all patients had improvement in their LS stage postoperatively. However, > 90% of the patients in the knee group had LS stage 2 postoperatively.

Conclusion

Nearly all elderly patients requiring surgeries for degenerative diseases of the lumbar spine and lower extremities had advanced conditions (LS stage 2). Surgeries could be beneficial in alleviating LS. The LS stage 3 criteria should be established, and the use of the GLFS-25 assessment can be appropriate for advanced LS patients with severe musculoskeletal diseases requiring surgeries.
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Metadata
Title
Improvement of locomotive syndrome with surgical treatment in patients with degenerative diseases in the lumbar spine and lower extremities: a prospective cohort study
Authors
Satoshi Kato
Yuki Kurokawa
Tamon Kabata
Satoru Demura
Hidenori Matsubara
Yoshitomo Kajino
Yoshiyuki Okamoto
Hiroaki Kimura
Kazuya Shinmura
Kentaro Igarashi
Takaki Shimizu
Noritaka Yonezawa
Noriaki Yokogawa
Hiroyuki Tsuchiya
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03547-0

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