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Balancing ability of patients with lumbar spinal canal stenosis

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Abstract

Purpose

To determine the relationship between postural sway and the severity of lumbar spinal canal stenosis as well as the effect on postoperative improvement.

Methods

Stabilometry was performed before and 6 months after surgery in 52 patients (29 men and 23 women; mean age, 74.1 ± 7.8 years) who underwent decompression surgery for lumbar spinal canal stenosis. The environmental area (EA; the area surrounding the circumference of the stabilogram) and locus length per EA (L/EA) were evaluated. The patients were divided into moderate (n = 22) and severe (n = 30) groups according to the severity of canal stenosis. Patient characteristics and parameters were compared between the groups before and after surgery, including the visual analog scale (VAS) score for leg pain, Oswestry Disability Index (ODI), EA, and L/EA. In addition, factors affecting EA and L/EA were evaluated using multiple regression analysis.

Results

Age (p = 0.031), preoperative EA (p < 0.001), preoperative L/EA (p = 0.032), and sagittal vertical axis (p = 0.033) were significantly different between groups. The VAS score and ODI significantly improved postoperatively in both groups (p < 0.001). The EA significantly improved postoperatively only in the severe group (p < 0.001), whereas the L/EA did not significantly improve in either group. Multiple regression analysis showed that only the severity of canal stenosis was significantly associated with preoperative EA (p = 0.030), whereas age (p = 0.040) and severity of canal stenosis (p = 0.030) were significantly associated with preoperative L/EA. Diabetes was significantly associated with postoperative EA (p = 0.046) and L/EA (p = 0.030).

Conclusion

The severity of canal stenosis affected abnormal postural sway, which improved after decompression surgery.

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Data availability

The datasets generated and/or analyzed in this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

No funds were received in support of this work.

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Author notes

  1. Satoshi Ujigo and Naosuke Kamei have contributed equally to this word and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hatsukaichi, Japan

    Satoshi Ujigo, Kiyotaka Yamada & Yoshinori Fujimoto

  2. Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Naosuke Kamei, Toshio Nakamae & Nobuo Adachi

  3. Department of Orthopaedic Surgery, Higashihiroshima Medical Center, Higashihiroshima, Japan

    Hideaki Imada

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  1. Satoshi Ujigo
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Correspondence to Naosuke Kamei.

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Ujigo, S., Kamei, N., Yamada, K. et al. Balancing ability of patients with lumbar spinal canal stenosis. Eur Spine J 32, 4174–4183 (2023). https://doi.org/10.1007/s00586-023-07782-6

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  • DOI: https://doi.org/10.1007/s00586-023-07782-6

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