Lumbar spinal stenosis (LSS) can interfere with daily life and quality of life (QOL). Evaluating physical function and QOL and helping them to improve is the focus of rehabilitation. Phase angle (PhA) assessment is widely used to measure body composition and is considered an indicator of physical function and QOL. This study investigated the relationship between PhA and physical function, physical activity, and QOL in patients with LSS. PhA, handgrip strength, walking speed, Timed Up and Go test (TUG), Life Space Assessment (LSA), Prognostic Nutritional Index (PNI), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and EQ-5D were assessed and statistically analyzed. The study included 104 patients with LSS. Multiple regression analysis of PhA adjusted for age, sex, and body mass index (Model 1) and for Model 1 + PNI (Model 2) showed significant correlations (P < 0.05) with handgrip strength, walking speed, TUG, and LSA. Regarding QOL, PhA showed a significant correlation (P < 0.05) with lumbar function in JOABPEQ and a significant trend (P < 0.1) in EQ-5D in both models. PhA was associated with physical function and QOL in patients with LSS and may be a new clinical indicator in this population.

Objectives Locomotive syndrome (LS) is characterized by reduced mobility. Clinical decision limit (CDL) stage 3 in LS indicates physical frailty. Lumbar spinal canal stenosis (LSS) is one cause of LS, for which lumbar surgery is considered to improve the CDL stage. This study aimed to investigate the efficacy of lumbar surgery and independent factors for improving CDL stage in patients with LSS. Design A retrospective study Setting The study was conducted at the Department of Orthopaedic Surgery at University Hospital. Participants A total of 157 patients aged 65 and over with LSS underwent lumbar surgery. Interventions: The 25-Question Geriatric Locomotive Function scale (GLFS-25) was used to test for LS, and the timed up and go test (TUG) was used to evaluate functional ability. Lower limb pain was evaluated using a visual analog scale. Patients with at least one improvement in CDL stage following lumbarsurgery were included in the improvement group. Differences in lower-limb pain intensity between the groups were evaluated using the Wilcoxon rank-sum test. Spearman rank correlation coefficient was used to determine correlations between delta lower limb pain and delta GLFS-25. Logistic regression analysis was used to identify factors associated with improvement in LS. Results: The proportion of patients with improved CDL stage was 45.1% (improvement/non-improvement: 32/39). delta Lower limb pain was significantly reduced in the improvement group compared to that in the non-improvement group (51.0 [36.3-71.0] vs 40.0 [4.0-53.5]; p =0.0107). delta GLFS-25 significantly correlated with delta lower-limb pain (r =0.3774, p =0.0031). In a multiple logistic regression analysis, TUG and age were significantly associated with improvement in LS (odds ratio, 1.22; 95% confidence interval: 1.07-1.47). Conclusions: The lumbar surgery effectively improved the CDL stage in patients with LSS. In addition, TUG was an independent factor associated with improvement in the CDL.

Background: Surgical site infection following spinal surgery causes prolonged delay in recovery after surgery, increases cost, and sometimes leads to additional surgical procedures. We investigated risk factors for the occurrence of surgical site infection events in terms of patient-related, surgery-related, and postoperative factors. Methods: This retrospective study included 1000 patients who underwent spinal surgery in our hospital between April 2016 and March 2019. Results: Patient-related factors were dementia, length of preoperative hospital stay (＞ _ 14 days), and diagnosis at the time of surgery (traumatic injury or deformity). The one surgery-related factor was multilevel surgery (＞ _ 9 intervertebral levels), and the one postoperative factor was time to ambulation (＞ _ 7 days) were statistically significant risk factors for spinal surgical site infection. Conclusion:One risk factor identified in this study that is amenable to intervention is time to ambulation. As delayed ambulation is a risk factor for postoperative surgical site infection, how medical staff can intervene in postoperative ambulation to further reduce the incidence of surgical site infection is a topic for future research.

Purpose Lumbar spinal stenosis (LSS) causes various symptoms, which can interfere with daily life and Quality of Life (QOL). Evaluating both patients’ physical function and QOL and helping them to improve is the focus of rehabilitation. Phase angle (PhA) assessment has been widely used to measure body composition, and it has been reported to reflect physical function and QOL. The purpose of this study was to investigate the relationship between PhA and physical function, physical activity, and QOL in patients with LSS. Methods PhA, handgrip strength, walking speed, timed up and go test (TUG), Life Space Assessment (LSA), Prognostic Nutritional Index (PNI), Japanese Orthopaedic Association back pain evaluation questionnaire (JOABPEQ), and EQ-5D were assessed. Multiple regression analysis was conducted to investigate the relationship of PhA to physical function, physical activity, and QOL using. Results Statistical analysis was performed on 104 patients with LSS. The results of multiple regression analysis of PhA adjusted for age, gender, and BMI (Model 1) and PhA adjusted for age, gender, BMI, and PNI (Model 2) compared with physical function and physical activity showed significant correlations respectively (P<0.05) in handgrip strength, walking speed, TUG, and LSA. In QOL assessment, both models showed a significant correlation (P<0.05) with lumbar function in JOABPEQ and a significant trend (P<0.1) in EQ-5D. Conclusion PhA in LSS patients in this study was associated with physical function and QOL, and may be a useful new tool for clinical evaluation in preoperative LSS patients.

Background Locomotive syndrome (LS) is characterized by reduced mobility. Clinical decision limit (CDL) stage 3 in LS indicates physical frailty. Lumbar spinal canal stenosis (LSS) is one of the causes of LS, for which lumbar surgery is considered to improve the CDL stage. This study aimed to investigate the efficacy of lumbar surgery and independent factors for improving the CDL stage in patients with LSS. Methods This retrospective study was conducted at the Department of Orthopaedic Surgery at our University Hospital. A total of 157 patients aged ≥ 65 years with LSS underwent lumbar surgery. The 25-Question Geriatric Locomotive Function scale (GLFS-25) was used to test for LS, and the Timed Up and Go test (TUG) was used to evaluate functional ability. Lower limb pain was evaluated using a visual analog scale. Patients with at least one improvement in the CDL stage following lumbar surgery were included in the improvement group. Differences in lower limb pain intensity between the groups were evaluated using the Wilcoxon rank-sum test. The Spearman’s rank correlation coefficient was used to determine correlations between Δ lower limb pain and Δ GLFS-25. Logistic regression analysis was used to identify factors associated with improvement in LS. Results The proportion of patients with improved CDL stage was 45.1% (improvement/non-improvement: 32/39). Δ Lower limb pain was significantly reduced in the improvement group compared with that in the non-improvement group (51.0 [36.3–71.0] vs 40.0 [4.0-53.5]; p = 0.0107). Δ GLFS-25 was significantly correlated with Δ lower limb pain (r = 0.3774, p = 0.0031). Multiple logistic regression analysis revealed that TUG and age were significantly associated with improvement in LS (odds ratio, 1.22; 95% confidence interval: 1.07–1.47). Conclusions Lumbar surgery effectively improved the CDL stage in patients with LSS. In addition, TUG was an independent factor associated with improvement in the CDL.