Surgery Can Improve Locomotive Syndrome Due to Lumbar Spinal Canal Stenosis and Loco-Check Can Predict Best Timing of Surgery to Avoid Progress of Locomotive Syndrome

• Published in: Spine Surgery and Related Research 2022/01/27, Vol.6(1), pp.58-62
• Main Authors: Shigematsu, Hideki, Tanaka, Masato, Kawasaki, Sachiko, Masuda, Keisuke, Suga, Yuma, Yamamoto, Yusuke, Tanaka, Yasuhito
• Format: Article
• Language: English
• Subjects: elderly; Japanese Orthopaedic Association score; loco-check; locomotive syndrome; lumbar spinal canal stenosis; Original; surgery
• ISSN: 2432-261X; 2432-261X
• DOI: 10.22603/ssrr.2021-0046

Introduction: The loco-check is a simple tool for evaluating locomotive syndrome (LS), and a previous report suggested that it can be used to identify patients with stage 2 LS. The purpose of this study was to investigate the improvement in LS stage after surgery based on the loco-check in elderly patients with lumbar spinal stenosis (LSS) and to clarify the characteristics associated with improvement to non-stage 2 LS.Methods: We reviewed 40 elderly patients with LSS who underwent surgery at our institution. We compared the pre- and postoperative Japanese Orthopaedic Association score, loco-check, Oswestry Disability Index, EuroQoL-5 dimension utility values, and the EuroQoL-visual analog scale. We divided patients according to the presence or absence of stage 2 LS after surgery and compared their preoperative clinical findings and assessment measures.Results: Ninety percent of all patients had been preoperatively diagnosed with stage 2 LS according to the loco-check. After surgery, patients showed a decreased number of affirmative answers on the loco-check, according to which only 65% were postoperatively diagnosed with stage 2 LS. The receiver operating characteristic curve analysis identified less than four affirmative answers on the loco-check before LSS as predictive of improvement to non-stage 2 LS.Conclusions: Surgical treatment for elderly patients with LSS could improve LS. In patients with less than four affirmative answers on the loco-check preoperatively, improvement to non-stage 2 LS status may be possible.