Preoperative low muscle mass is a predictor of falls within 12 months of surgery in patients with lumbar spinal stenosis

Abstract

Background Patients with lumbar spinal stenosis (LSS) may be at high risk of falls due to various factors. No effective fall risk assessments or fall prevention measures have been performed for patients with LSS because only a few studies have evaluated falls in these patients. This study aimed to evaluate the incidence and preoperative predictors of falls within 12 months of surgery in patients with LSS. Methods In this prospective study of 82 consecutive preoperative patients with LSS, preoperative demographic data, previous fall history, leg pain, low back pain, Japanese Orthopaedic Association (JOA) score, Hospital Anxiety and Depression Scale (HADS) scores, lower extremity muscle strength, walking speed, grip strength, and muscle mass were assessed at baseline. Falls were assessed at 3, 6, 9, and 12 months after surgery. Participants were categorized as fallers and non-fallers and baseline variables were compared. Binomial logistic regression was used to identify predictors of falls within 12 months of surgery. Results Seventy-four patients (90.2%) completed the 12-month follow-up after surgery, of whom 24 patients (32.4%) experienced falls. A higher proportion of fallers were female and had a history of falls compared to non-fallers. Fallers had a significantly lower JOA score and a higher HADS-depression score compared to non-fallers. Fallers had significantly lower tibialis anterior muscle strength, gait speed, grip strength, and skeletal muscle mass index. Fallers had a higher prevalence of low muscle mass compared with non-fallers. The presence of low muscle mass was significantly predictive of falls within 12 months of surgery (odds ratio, 4.46; 95% confidence interval, 1.02–19.63). Conclusions Patients with LSS have a high incidence of falls after surgery and preoperative low muscle mass may be a predictor of postoperative falls.

Prehabilitation for Patients Undergoing Orthopedic Surgery

“…4 Waiting for a surgical procedure therefore provides a window of opportunity to optimize and influence the preoperative muscle strength, function, and health-related quality of life (HRQOL) of a patient, which are often considered predictive factors associated with postoperative outcomes in the population undergoing orthopedic surgery. [5][6][7][8] This is termed prehabilitation. 9 Although prehabilitation has been reported in the literature since the 1940s, the role of prehabilitation in improving postoperative outcomes has only been researched from the year 2000.…”

Critical evaluation of commonly used methods to determine the concordance between sonography and magnetic resonance imaging: A comparative study

“…Increasing muscle mass is of high importance in (elite) sports (Del Vecchio et al, 2019;Kordi et al, 2020;Zaras et al, 2021), prevention -especially in age-related diseases such as sarcopenia (English and Paddon-Jones, 2010;Lopes et al, 2019;Vikberg et al, 2019) -and rehabilitation of orthopedic indications (Wada et al, 2020). Consequently, several training methods aim to improve muscle mass which is usually measured via muscle thickness (MT) or muscle cross-sectional area (MCSA) (Schoenfeld et al, 2016;Simpson et al, 2017;Wackerhage et al, 2019;May et al, 2021), also in rehabilitative settings (Guthrie et al, 2012;Larivière et al, 2019;Padulo et al, 2020).…”

Physical Predictors of Favorable Postoperative Outcomes in Patients Undergoing Laminectomy or Laminotomy for Central Lumbar Spinal Stenosis: Secondary Analysis of a Randomized Controlled Trial

“…Furthermore, gait measurements derived from a smart-shoe technology showed promising results for predicting postoperative pain intensity and low back disability outcomes (39). Finally, a preoperative body mass index ≤29.1 kg/m 2 was reported to be associated with higher surgical success at 2-year follow-up (40) and the presence of skeletal low muscle mass has been shown to be a significant predictor of falls within 12-months of surgery (41).…”