Comparison of Effects of Nonoperative Treatment and Decompression Surgery on Risk of Patients with Lumbar Spinal Stenosis Falling: Evaluation with Functional Mobility Tests
BACKGROUND:Falls are a major factor contributing to fragility fractures. Patients with lumbar spinal stenosis have an increased risk of falling. We are aware of no prior report demonstrating the effect of medical treatment and decompression surgery on the risk of patients with lumbar spinal stenosis...
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| Veröffentlicht in: | Journal of bone and joint surgery. American volume 2014-07, Vol.96 (13), p.e110-e110 |
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| container_title | Journal of bone and joint surgery. American volume |
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| creator | Lee, Byung Ho Kim, Tae-Hwan Park, Moon-Soo Lim, Suhan Park, Jin-Oh Kim, Hak-Sun Kim, Ho-Joong Lee, Hwan-Mo Moon, Seong-Hwan |
| description | BACKGROUND:Falls are a major factor contributing to fragility fractures. Patients with lumbar spinal stenosis have an increased risk of falling. We are aware of no prior report demonstrating the effect of medical treatment and decompression surgery on the risk of patients with lumbar spinal stenosis falling.
METHODS:From June to November 2011, seventy-six patients were enrolled into the surgery group and fifty patients, into the nonoperative group. Four functional mobility tests, including the Alternate-Step test, Six-Meter Walk test, Sit-to-Stand test, and timed “Up & Go” test, were used to evaluate the risk of falling. The Oswestry Disability Index (ODI) and the EuroQoL-5D (EQ-5D) visual analog scale (VAS) were utilized to assess clinical improvement.
RESULTS:The mean age was 62.4 years in the surgery group and 64.6 years in the nonoperative group. The results of the Alternate-Step test significantly improved during the follow-up period in the surgery group (p = 0.001). However, the results of the Alternate-Step test significantly worsened during the follow-up period in the nonoperative group (p = 0.001). Comparison between the two groups showed more significant improvement in the surgery group, especially for the Six-Meter Walk test at one year postoperatively (p = 0.042) and for the timed “Up & Go” test at three months and one year (p = 0.046 and 0.000). However, the ODI and EQ-5D VAS scores improved in both groups. In a linear mixed model, age, surgery, and the presence of an osteoporotic compression fracture significantly affected the test results related to the risk of falling (p < 0.05).
CONCLUSIONS:The surgery group showed a greater decrease in the risk of falling than those in the nonoperative group. Improved physical performance, including walking and balancing, after decompression lumbar spinal surgery reduces the future risk of falling.
LEVEL OF EVIDENCE:Therapeutic Level II. Retrospective analysis of prospectively collected data. See Instructions for Authors for a complete description of levels of evidence. |
| doi_str_mv | 10.2106/JBJS.M.00427 |
| format | Article |
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METHODS:From June to November 2011, seventy-six patients were enrolled into the surgery group and fifty patients, into the nonoperative group. Four functional mobility tests, including the Alternate-Step test, Six-Meter Walk test, Sit-to-Stand test, and timed “Up & Go” test, were used to evaluate the risk of falling. The Oswestry Disability Index (ODI) and the EuroQoL-5D (EQ-5D) visual analog scale (VAS) were utilized to assess clinical improvement.
RESULTS:The mean age was 62.4 years in the surgery group and 64.6 years in the nonoperative group. The results of the Alternate-Step test significantly improved during the follow-up period in the surgery group (p = 0.001). However, the results of the Alternate-Step test significantly worsened during the follow-up period in the nonoperative group (p = 0.001). Comparison between the two groups showed more significant improvement in the surgery group, especially for the Six-Meter Walk test at one year postoperatively (p = 0.042) and for the timed “Up & Go” test at three months and one year (p = 0.046 and 0.000). However, the ODI and EQ-5D VAS scores improved in both groups. In a linear mixed model, age, surgery, and the presence of an osteoporotic compression fracture significantly affected the test results related to the risk of falling (p < 0.05).
CONCLUSIONS:The surgery group showed a greater decrease in the risk of falling than those in the nonoperative group. Improved physical performance, including walking and balancing, after decompression lumbar spinal surgery reduces the future risk of falling.
LEVEL OF EVIDENCE:Therapeutic Level II. Retrospective analysis of prospectively collected data. See Instructions for Authors for a complete description of levels of evidence.</description><identifier>ISSN: 0021-9355</identifier><identifier>EISSN: 1535-1386</identifier><identifier>DOI: 10.2106/JBJS.M.00427</identifier><identifier>PMID: 24990984</identifier><language>eng</language><publisher>United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated</publisher><subject>Accidental Falls ; Aged ; Decompression, Surgical ; Disability Evaluation ; Female ; Humans ; Lumbar Vertebrae - surgery ; Male ; Middle Aged ; Postural Balance - physiology ; Quality of Life ; Range of Motion, Articular - physiology ; Risk ; Spinal Stenosis - surgery ; Spinal Stenosis - therapy ; Treatment Outcome</subject><ispartof>Journal of bone and joint surgery. American volume, 2014-07, Vol.96 (13), p.e110-e110</ispartof><rights>Copyright 2014 by The Journal of Bone and Joint Surgery, Incorporated</rights><rights>Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2086-e9c5d40792a75266cf18e65f797200c8ca7676e48a37e65e45da71017448bbb23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24990984$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Byung Ho</creatorcontrib><creatorcontrib>Kim, Tae-Hwan</creatorcontrib><creatorcontrib>Park, Moon-Soo</creatorcontrib><creatorcontrib>Lim, Suhan</creatorcontrib><creatorcontrib>Park, Jin-Oh</creatorcontrib><creatorcontrib>Kim, Hak-Sun</creatorcontrib><creatorcontrib>Kim, Ho-Joong</creatorcontrib><creatorcontrib>Lee, Hwan-Mo</creatorcontrib><creatorcontrib>Moon, Seong-Hwan</creatorcontrib><title>Comparison of Effects of Nonoperative Treatment and Decompression Surgery on Risk of Patients with Lumbar Spinal Stenosis Falling: Evaluation with Functional Mobility Tests</title><title>Journal of bone and joint surgery. American volume</title><addtitle>J Bone Joint Surg Am</addtitle><description>BACKGROUND:Falls are a major factor contributing to fragility fractures. Patients with lumbar spinal stenosis have an increased risk of falling. We are aware of no prior report demonstrating the effect of medical treatment and decompression surgery on the risk of patients with lumbar spinal stenosis falling.
METHODS:From June to November 2011, seventy-six patients were enrolled into the surgery group and fifty patients, into the nonoperative group. Four functional mobility tests, including the Alternate-Step test, Six-Meter Walk test, Sit-to-Stand test, and timed “Up & Go” test, were used to evaluate the risk of falling. The Oswestry Disability Index (ODI) and the EuroQoL-5D (EQ-5D) visual analog scale (VAS) were utilized to assess clinical improvement.
RESULTS:The mean age was 62.4 years in the surgery group and 64.6 years in the nonoperative group. The results of the Alternate-Step test significantly improved during the follow-up period in the surgery group (p = 0.001). However, the results of the Alternate-Step test significantly worsened during the follow-up period in the nonoperative group (p = 0.001). Comparison between the two groups showed more significant improvement in the surgery group, especially for the Six-Meter Walk test at one year postoperatively (p = 0.042) and for the timed “Up & Go” test at three months and one year (p = 0.046 and 0.000). However, the ODI and EQ-5D VAS scores improved in both groups. In a linear mixed model, age, surgery, and the presence of an osteoporotic compression fracture significantly affected the test results related to the risk of falling (p < 0.05).
CONCLUSIONS:The surgery group showed a greater decrease in the risk of falling than those in the nonoperative group. Improved physical performance, including walking and balancing, after decompression lumbar spinal surgery reduces the future risk of falling.
LEVEL OF EVIDENCE:Therapeutic Level II. Retrospective analysis of prospectively collected data. See Instructions for Authors for a complete description of levels of evidence.</description><subject>Accidental Falls</subject><subject>Aged</subject><subject>Decompression, Surgical</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postural Balance - physiology</subject><subject>Quality of Life</subject><subject>Range of Motion, Articular - physiology</subject><subject>Risk</subject><subject>Spinal Stenosis - surgery</subject><subject>Spinal Stenosis - therapy</subject><subject>Treatment Outcome</subject><issn>0021-9355</issn><issn>1535-1386</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kcGO0zAURS0EYsrAjjXykgUptpPYCTso7QyjFhAt68hxX6ZmnDjYyVT9Jz6Sl-nAyvbTucd6uoS85mwuOJPvbz7dbOebOWOZUE_IjOdpnvC0kE_JjDHBkzLN8wvyIsZfDJmMqefkQmRlycoim5E_C9_2OtjoO-obumwaMEOcrl9953sIerD3QHcB9NBCN1Dd7elnMJgKEKPF2HYMtxBOFK8_bLybst8xhXCkRzsc6Hpsax3otreddnQ7QOejjXSlnbPd7Qe6vNduxAQKHvjV2JnphfDG19bZ4UR3EIf4kjxrtIvw6vG8JD9Xy93iOll_u_qy-LhOjGCFTKA0-R4XLYVWuZDSNLwAmTeqVIIxUxitpJKQFTpVOIcs32vFGVdZVtR1LdJL8vbs7YP_PeLPVWujAed0B36MFS_QynImCkTfnVETfIwBmqoPttXhVHFWTf1UUz_VpnroB_E3j-axbmH_H_5XCALZGTh6N0CId248QqgOoN1wQAlqpEgTwTguyARLcMJl-hcUb52N</recordid><startdate>20140702</startdate><enddate>20140702</enddate><creator>Lee, Byung Ho</creator><creator>Kim, Tae-Hwan</creator><creator>Park, Moon-Soo</creator><creator>Lim, Suhan</creator><creator>Park, Jin-Oh</creator><creator>Kim, Hak-Sun</creator><creator>Kim, Ho-Joong</creator><creator>Lee, Hwan-Mo</creator><creator>Moon, Seong-Hwan</creator><general>Copyright by The Journal of Bone and Joint Surgery, Incorporated</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140702</creationdate><title>Comparison of Effects of Nonoperative Treatment and Decompression Surgery on Risk of Patients with Lumbar Spinal Stenosis Falling: Evaluation with Functional Mobility Tests</title><author>Lee, Byung Ho ; Kim, Tae-Hwan ; Park, Moon-Soo ; Lim, Suhan ; Park, Jin-Oh ; Kim, Hak-Sun ; Kim, Ho-Joong ; Lee, Hwan-Mo ; Moon, Seong-Hwan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2086-e9c5d40792a75266cf18e65f797200c8ca7676e48a37e65e45da71017448bbb23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Accidental Falls</topic><topic>Aged</topic><topic>Decompression, Surgical</topic><topic>Disability Evaluation</topic><topic>Female</topic><topic>Humans</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postural Balance - physiology</topic><topic>Quality of Life</topic><topic>Range of Motion, Articular - physiology</topic><topic>Risk</topic><topic>Spinal Stenosis - surgery</topic><topic>Spinal Stenosis - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Byung Ho</creatorcontrib><creatorcontrib>Kim, Tae-Hwan</creatorcontrib><creatorcontrib>Park, Moon-Soo</creatorcontrib><creatorcontrib>Lim, Suhan</creatorcontrib><creatorcontrib>Park, Jin-Oh</creatorcontrib><creatorcontrib>Kim, Hak-Sun</creatorcontrib><creatorcontrib>Kim, Ho-Joong</creatorcontrib><creatorcontrib>Lee, Hwan-Mo</creatorcontrib><creatorcontrib>Moon, Seong-Hwan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of bone and joint surgery. American volume</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Byung Ho</au><au>Kim, Tae-Hwan</au><au>Park, Moon-Soo</au><au>Lim, Suhan</au><au>Park, Jin-Oh</au><au>Kim, Hak-Sun</au><au>Kim, Ho-Joong</au><au>Lee, Hwan-Mo</au><au>Moon, Seong-Hwan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Effects of Nonoperative Treatment and Decompression Surgery on Risk of Patients with Lumbar Spinal Stenosis Falling: Evaluation with Functional Mobility Tests</atitle><jtitle>Journal of bone and joint surgery. American volume</jtitle><addtitle>J Bone Joint Surg Am</addtitle><date>2014-07-02</date><risdate>2014</risdate><volume>96</volume><issue>13</issue><spage>e110</spage><epage>e110</epage><pages>e110-e110</pages><issn>0021-9355</issn><eissn>1535-1386</eissn><abstract>BACKGROUND:Falls are a major factor contributing to fragility fractures. Patients with lumbar spinal stenosis have an increased risk of falling. We are aware of no prior report demonstrating the effect of medical treatment and decompression surgery on the risk of patients with lumbar spinal stenosis falling.
METHODS:From June to November 2011, seventy-six patients were enrolled into the surgery group and fifty patients, into the nonoperative group. Four functional mobility tests, including the Alternate-Step test, Six-Meter Walk test, Sit-to-Stand test, and timed “Up & Go” test, were used to evaluate the risk of falling. The Oswestry Disability Index (ODI) and the EuroQoL-5D (EQ-5D) visual analog scale (VAS) were utilized to assess clinical improvement.
RESULTS:The mean age was 62.4 years in the surgery group and 64.6 years in the nonoperative group. The results of the Alternate-Step test significantly improved during the follow-up period in the surgery group (p = 0.001). However, the results of the Alternate-Step test significantly worsened during the follow-up period in the nonoperative group (p = 0.001). Comparison between the two groups showed more significant improvement in the surgery group, especially for the Six-Meter Walk test at one year postoperatively (p = 0.042) and for the timed “Up & Go” test at three months and one year (p = 0.046 and 0.000). However, the ODI and EQ-5D VAS scores improved in both groups. In a linear mixed model, age, surgery, and the presence of an osteoporotic compression fracture significantly affected the test results related to the risk of falling (p < 0.05).
CONCLUSIONS:The surgery group showed a greater decrease in the risk of falling than those in the nonoperative group. Improved physical performance, including walking and balancing, after decompression lumbar spinal surgery reduces the future risk of falling.
LEVEL OF EVIDENCE:Therapeutic Level II. Retrospective analysis of prospectively collected data. See Instructions for Authors for a complete description of levels of evidence.</abstract><cop>United States</cop><pub>Copyright by The Journal of Bone and Joint Surgery, Incorporated</pub><pmid>24990984</pmid><doi>10.2106/JBJS.M.00427</doi></addata></record> |
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| ispartof | Journal of bone and joint surgery. American volume, 2014-07, Vol.96 (13), p.e110-e110 |
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| subjects | Accidental Falls Aged Decompression, Surgical Disability Evaluation Female Humans Lumbar Vertebrae - surgery Male Middle Aged Postural Balance - physiology Quality of Life Range of Motion, Articular - physiology Risk Spinal Stenosis - surgery Spinal Stenosis - therapy Treatment Outcome |
| title | Comparison of Effects of Nonoperative Treatment and Decompression Surgery on Risk of Patients with Lumbar Spinal Stenosis Falling: Evaluation with Functional Mobility Tests |
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