Otani Koji, Kikuchi Shin-Ichi, Yabuki Shoji, Onda Akira, Nikaido Takuya, Watanabe Kazuyuki, Konno Shin-Ichi
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
J Pain Res. 2018 Mar 2;11:455-464. doi: 10.2147/JPR.S148402. eCollection 2018.
Lumbar spinal stenosis (LSS) is a common condition in the aging population. However, limited information exists on discrepancies between LSS symptoms and imaging findings and/or prognostic factors of LSS, as well as the relationship between changes in LSS symptoms and quality of life (QoL) during the natural course of LSS. The purpose of the current study was to clarify any changes in clinically diagnosed LSS at a one-year follow-up, and identify its prognostic factors, using a community-dwelling cohort.
In this study, the presence of LSS, its associated comorbidities, and the status of QoL pertaining to general health and low-back pain were assessed in 1,080 community-dwelling volunteers. The same assessment was carried out a year after the initial survey. Clinically diagnosis as LSS (LSS-positive) was determined by a validated diagnostic support tool in the form of a self-administered, self-reported history questionnaire. QoL was assessed using the 36-Item Short Form Health Survey and the Roland-Morris Disability Questionnaire.
Among subjects who were LSS-positive in the initial assessment, 54% were clinically diagnosed as negative for LSS (LSS-negative) after the one-year period, whereas 10% of those who were initially diagnosed as LSS-negative changed to LSS-positive during the same period. With the improvement or deterioration of LSS-positive/negative status, low-back pain-related QoL and some components of the 36-Item Short Form Health Survey similarly improved or deteriorated. Decisive prognostic factors of LSS-positive status were not determined at the one-year follow-up.
Approximately half of the subjects who had initially been diagnosed as LSS-positive converted to LSS-negative after one year. Prognostic factors of LSS-positive diagnosis after one-year follow-up were not detected.
腰椎管狭窄症（LSS）在老年人群中很常见。然而，关于LSS症状与影像学表现之间的差异和/或LSS的预后因素，以及LSS自然病程中LSS症状变化与生活质量（QoL）之间的关系，目前的信息有限。本研究的目的是通过一个社区居住队列，阐明临床诊断的LSS在一年随访中的任何变化，并确定其预后因素。
在本研究中，对1080名社区居住志愿者进行了LSS的存在情况、其相关合并症以及与一般健康和腰痛相关的QoL状况评估。在初次调查一年后进行了相同的评估。通过一种经过验证的诊断支持工具，即自我管理、自我报告的病史问卷，确定临床诊断为LSS（LSS阳性）。使用36项简短健康调查和罗兰-莫里斯残疾问卷评估QoL。
在初次评估中LSS阳性的受试者中，54%在一年后临床诊断为LSS阴性（LSS阴性），而最初诊断为LSS阴性的受试者中有10%在同一时期转变为LSS阳性。随着LSS阳性/阴性状态的改善或恶化，与腰痛相关的QoL和36项简短健康调查的一些组成部分也同样改善或恶化。在一年随访中未确定LSS阳性状态的决定性预后因素。
大约一半最初被诊断为LSS阳性的受试者在一年后转变为LSS阴性。未检测到一年随访后LSS阳性诊断的预后因素。
