Comparison of effects of nonoperative treatment and decompression surgery on risk of patients with lumbar spinal stenosis falling

Evaluation with functional mobility tests

Byung Ho Lee, Tae Hwan Kim, Moon Soo Park, Suhan Lim, Jin Oh Park, Hak Sun Kim, Ho Joong Kim, Hwan Mo Lee, seonghwan moon

Research output: Contribution to journalArticle

9 Citations (Scopus)

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,wereused toevaluate therisk 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.

Original languageEnglish
Pages (from-to)e110(1)
JournalJournal of Bone and Joint Surgery - American Volume
Volume96
Issue number13
DOIs
Publication statusPublished - 2014 Jul 2

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Accidental Falls
Spinal Stenosis
Decompression
Exercise Test
Therapeutics
Visual Analog Scale
Compression Fractures
Osteoporotic Fractures
Walking
Linear Models

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Lee, Byung Ho ; Kim, Tae Hwan ; Park, Moon Soo ; Lim, Suhan ; Park, Jin Oh ; Kim, Hak Sun ; Kim, Ho Joong ; Lee, Hwan Mo ; moon, seonghwan. / Comparison of effects of nonoperative treatment and decompression surgery on risk of patients with lumbar spinal stenosis falling : Evaluation with functional mobility tests. In: Journal of Bone and Joint Surgery - American Volume. 2014 ; Vol. 96, No. 13. pp. e110(1).
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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,wereused toevaluate therisk 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.",
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Comparison of effects of nonoperative treatment and decompression surgery on risk of patients with lumbar spinal stenosis falling : Evaluation with functional mobility tests. / Lee, Byung Ho; Kim, Tae Hwan; Park, Moon Soo; Lim, Suhan; Park, Jin Oh; Kim, Hak Sun; Kim, Ho Joong; Lee, Hwan Mo; moon, seonghwan.

In: Journal of Bone and Joint Surgery - American Volume, Vol. 96, No. 13, 02.07.2014, p. e110(1).

Research output: Contribution to journalArticle

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T1 - Comparison of effects of nonoperative treatment and decompression surgery on risk of patients with lumbar spinal stenosis falling

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AU - Lee, Byung Ho

AU - Kim, Tae Hwan

AU - Park, Moon Soo

AU - Lim, Suhan

AU - Park, Jin Oh

AU - Kim, Hak Sun

AU - Kim, Ho Joong

AU - Lee, Hwan Mo

AU - moon, seonghwan

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N2 - 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,wereused toevaluate therisk 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.

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