Spinal sagittal balance status affects postoperative actual falls and quality of life after decompression and fusion in-situ surgery in patients with lumbar spinal stenosis

Byung Ho Lee, Jin Oh Park, Hak Sun Kim, Kyung Soo Suk, Sang Yoon Lee, Hwan Mo Lee, Jae Ho Yang, seonghwan moon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives It has been reported that good spinal sagittal alignment reduces the risk of fall and positive sagittal balance is the radiographic parameter that is most highly correlated with adverse health outcomes. However, no reports have demonstrated a change in risk of falling in patients with lumbar spinal stenosis (LSS) according to sagittal balance status. Patients and methods From September 2013 to October 2014, 141 patients who underwent lumbar spine surgery, including decompression and fusion in-situ for LSS, were enrolled in this study. Based on sagittal balance status, patients were divided into sagittal balance (SB) and sagittal imbalance (SI) groups. Four functional mobility tests were used to evaluate the risk of falling, and a fall diary, Oswestry disability index (ODI), and the Euro-QoL 5D(EQ-5D) visual analogue scale (VAS) were utilized to assess clinical improvement. Results The mean patient age was 70.1 years in the SB group (N = 46) and 70.9 years in the SI group (N = 95) (not significant). The mean C7PL was 7.9 mm in the SB group and 66.1 mm in the SI group preoperatively (p < 0.05). Among the four functional tests, only postoperative SMT and STS improved significantly in the SB group (p < 0.05). Patients in the SI group showed significantly improved scores for all four functional tests during postoperative follow-up (p < 0.05), but their performance was still worse than patients in the SB group. Average number of falls per individual during the follow-up period was 1.1 ± 2.5 in the SB group and 1.9 ± 3.2 in the SI group (p < 0.05). There was a significant difference in the distribution of non-fallers and fallers (single and multiple fallers) between the two groups postoperatively(p < 0.05). ODI and the EQ-5D VAS showed greater improvement in the SB group than the SI group. Multiple regression analysis revealed that sagittal balance during follow-up significantly affected ODI, EQ-VAS, functional mobility tests. (p < 0.05). Conclusion Therefore, when fusion surgery is planned in patients with LSS, careful consideration of sagittal balance status might be important to attain better surgical and functional outcomes and decrease the incidence of actual falls after surgical treatment.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
JournalClinical Neurology and Neurosurgery
Volume148
DOIs
Publication statusPublished - 2016 Sep 1

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Spinal Stenosis
Decompression
Quality of Life
Accidental Falls
Visual Analog Scale
Spine
Regression Analysis
Incidence
Health

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

@article{64d31634c4004398bc44a92dce90e647,
title = "Spinal sagittal balance status affects postoperative actual falls and quality of life after decompression and fusion in-situ surgery in patients with lumbar spinal stenosis",
abstract = "Objectives It has been reported that good spinal sagittal alignment reduces the risk of fall and positive sagittal balance is the radiographic parameter that is most highly correlated with adverse health outcomes. However, no reports have demonstrated a change in risk of falling in patients with lumbar spinal stenosis (LSS) according to sagittal balance status. Patients and methods From September 2013 to October 2014, 141 patients who underwent lumbar spine surgery, including decompression and fusion in-situ for LSS, were enrolled in this study. Based on sagittal balance status, patients were divided into sagittal balance (SB) and sagittal imbalance (SI) groups. Four functional mobility tests were used to evaluate the risk of falling, and a fall diary, Oswestry disability index (ODI), and the Euro-QoL 5D(EQ-5D) visual analogue scale (VAS) were utilized to assess clinical improvement. Results The mean patient age was 70.1 years in the SB group (N = 46) and 70.9 years in the SI group (N = 95) (not significant). The mean C7PL was 7.9 mm in the SB group and 66.1 mm in the SI group preoperatively (p < 0.05). Among the four functional tests, only postoperative SMT and STS improved significantly in the SB group (p < 0.05). Patients in the SI group showed significantly improved scores for all four functional tests during postoperative follow-up (p < 0.05), but their performance was still worse than patients in the SB group. Average number of falls per individual during the follow-up period was 1.1 ± 2.5 in the SB group and 1.9 ± 3.2 in the SI group (p < 0.05). There was a significant difference in the distribution of non-fallers and fallers (single and multiple fallers) between the two groups postoperatively(p < 0.05). ODI and the EQ-5D VAS showed greater improvement in the SB group than the SI group. Multiple regression analysis revealed that sagittal balance during follow-up significantly affected ODI, EQ-VAS, functional mobility tests. (p < 0.05). Conclusion Therefore, when fusion surgery is planned in patients with LSS, careful consideration of sagittal balance status might be important to attain better surgical and functional outcomes and decrease the incidence of actual falls after surgical treatment.",
author = "Lee, {Byung Ho} and Park, {Jin Oh} and Kim, {Hak Sun} and Suk, {Kyung Soo} and Lee, {Sang Yoon} and Lee, {Hwan Mo} and Yang, {Jae Ho} and seonghwan moon",
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Spinal sagittal balance status affects postoperative actual falls and quality of life after decompression and fusion in-situ surgery in patients with lumbar spinal stenosis. / Lee, Byung Ho; Park, Jin Oh; Kim, Hak Sun; Suk, Kyung Soo; Lee, Sang Yoon; Lee, Hwan Mo; Yang, Jae Ho; moon, seonghwan.

In: Clinical Neurology and Neurosurgery, Vol. 148, 01.09.2016, p. 52-59.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Spinal sagittal balance status affects postoperative actual falls and quality of life after decompression and fusion in-situ surgery in patients with lumbar spinal stenosis

AU - Lee, Byung Ho

AU - Park, Jin Oh

AU - Kim, Hak Sun

AU - Suk, Kyung Soo

AU - Lee, Sang Yoon

AU - Lee, Hwan Mo

AU - Yang, Jae Ho

AU - moon, seonghwan

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objectives It has been reported that good spinal sagittal alignment reduces the risk of fall and positive sagittal balance is the radiographic parameter that is most highly correlated with adverse health outcomes. However, no reports have demonstrated a change in risk of falling in patients with lumbar spinal stenosis (LSS) according to sagittal balance status. Patients and methods From September 2013 to October 2014, 141 patients who underwent lumbar spine surgery, including decompression and fusion in-situ for LSS, were enrolled in this study. Based on sagittal balance status, patients were divided into sagittal balance (SB) and sagittal imbalance (SI) groups. Four functional mobility tests were used to evaluate the risk of falling, and a fall diary, Oswestry disability index (ODI), and the Euro-QoL 5D(EQ-5D) visual analogue scale (VAS) were utilized to assess clinical improvement. Results The mean patient age was 70.1 years in the SB group (N = 46) and 70.9 years in the SI group (N = 95) (not significant). The mean C7PL was 7.9 mm in the SB group and 66.1 mm in the SI group preoperatively (p < 0.05). Among the four functional tests, only postoperative SMT and STS improved significantly in the SB group (p < 0.05). Patients in the SI group showed significantly improved scores for all four functional tests during postoperative follow-up (p < 0.05), but their performance was still worse than patients in the SB group. Average number of falls per individual during the follow-up period was 1.1 ± 2.5 in the SB group and 1.9 ± 3.2 in the SI group (p < 0.05). There was a significant difference in the distribution of non-fallers and fallers (single and multiple fallers) between the two groups postoperatively(p < 0.05). ODI and the EQ-5D VAS showed greater improvement in the SB group than the SI group. Multiple regression analysis revealed that sagittal balance during follow-up significantly affected ODI, EQ-VAS, functional mobility tests. (p < 0.05). Conclusion Therefore, when fusion surgery is planned in patients with LSS, careful consideration of sagittal balance status might be important to attain better surgical and functional outcomes and decrease the incidence of actual falls after surgical treatment.

AB - Objectives It has been reported that good spinal sagittal alignment reduces the risk of fall and positive sagittal balance is the radiographic parameter that is most highly correlated with adverse health outcomes. However, no reports have demonstrated a change in risk of falling in patients with lumbar spinal stenosis (LSS) according to sagittal balance status. Patients and methods From September 2013 to October 2014, 141 patients who underwent lumbar spine surgery, including decompression and fusion in-situ for LSS, were enrolled in this study. Based on sagittal balance status, patients were divided into sagittal balance (SB) and sagittal imbalance (SI) groups. Four functional mobility tests were used to evaluate the risk of falling, and a fall diary, Oswestry disability index (ODI), and the Euro-QoL 5D(EQ-5D) visual analogue scale (VAS) were utilized to assess clinical improvement. Results The mean patient age was 70.1 years in the SB group (N = 46) and 70.9 years in the SI group (N = 95) (not significant). The mean C7PL was 7.9 mm in the SB group and 66.1 mm in the SI group preoperatively (p < 0.05). Among the four functional tests, only postoperative SMT and STS improved significantly in the SB group (p < 0.05). Patients in the SI group showed significantly improved scores for all four functional tests during postoperative follow-up (p < 0.05), but their performance was still worse than patients in the SB group. Average number of falls per individual during the follow-up period was 1.1 ± 2.5 in the SB group and 1.9 ± 3.2 in the SI group (p < 0.05). There was a significant difference in the distribution of non-fallers and fallers (single and multiple fallers) between the two groups postoperatively(p < 0.05). ODI and the EQ-5D VAS showed greater improvement in the SB group than the SI group. Multiple regression analysis revealed that sagittal balance during follow-up significantly affected ODI, EQ-VAS, functional mobility tests. (p < 0.05). Conclusion Therefore, when fusion surgery is planned in patients with LSS, careful consideration of sagittal balance status might be important to attain better surgical and functional outcomes and decrease the incidence of actual falls after surgical treatment.

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