J Back Musculoskelet Rehabil. 2021;34(3):469-476. doi: 10.3233/BMR-200138.
Sarcopenia has been found to affect the postoperative outcomes of lumbar surgery. The effect of sarcopenia on the clinical outcomes in patients who underwent stand-alone lateral lumbar interbody fusion (LLIF) has not yet been examined.
To investigate whether sarcopenia affects the Oswestry Disability Index (ODI) and visual analog scale (VAS) score for back pain following single-level stand-alone LLIF.
Patients who underwent a single level stand-alone LLIF for lumbar diseases were retrospectively investigated. Sarcopenia was defined according to the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. Patients were divided into the sarcopenia (SP) and non-sarcopenia (NSP) group. Univariate analysis was used to compare with regards to demographics and clinical outcomes. Multivariate logistic regression was performed to elucidate factors predicting poor clinically improvement.
Sixty-nine patients were enrolled, with 16 and 53 patients in the SP and NSP group respectively. In the SP group, patients were much older (P= 0.002), their body mass index was significantly lower (P< 0.001), the percent of women was higher (P= 0.042), and the skeletal muscle mass index (SMI) (P< 0.001) and gait speed were much lower (P= 0.005). The postoperative ODI scores were much higher and the improvement rate was much lower (both P< 0.001) in the SP group, whereas VAS scores for back pain showed no difference between the two groups. SMI and gait speed had a moderate and weak correlation with the final ODI score, respectively. Low SMI and low gait speed were independently associated with poor clinical outcomes at the final follow-up.
Sarcopenia impacts the final clinical outcomes of stand-alone LLIF for lumbar diseases. Low SMI and low gait speed were negative impact factors for the clinical improvement after stand-alone LLIF.
肌少症已被发现会影响腰椎手术的术后结果。肌少症对单纯侧路腰椎间融合术（LLIF）患者的临床结果的影响尚未被研究。
研究肌少症是否会影响单纯侧路腰椎间融合术（LLIF）后患者的 Oswestry 残疾指数（ODI）和腰痛视觉模拟评分（VAS）。
回顾性调查了因腰椎疾病行单节段单纯 LLIF 的患者。根据亚洲肌少症工作组推荐的诊断算法定义肌少症。将患者分为肌少症（SP）和非肌少症（NSP）组。采用单变量分析比较两组的人口统计学和临床结果。采用多变量逻辑回归分析明确预测临床改善不良的因素。
共纳入 69 例患者，其中 SP 组 16 例，NSP 组 53 例。在 SP 组中，患者年龄更大（P=0.002），体重指数更低（P<0.001），女性比例更高（P=0.042），骨骼肌质量指数（SMI）（P<0.001）和步态速度更低（P=0.005）。SP 组术后 ODI 评分更高，改善率更低（均 P<0.001），而两组腰痛 VAS 评分无差异。SMI 和步态速度与最终 ODI 评分分别具有中度和弱相关性。低 SMI 和低步态速度与最终随访时的不良临床结果独立相关。
肌少症影响单纯 LLIF 治疗腰椎疾病的最终临床结果。低 SMI 和低步态速度是单纯 LLIF 后临床改善的负面因素。
