Hachiya Kurenai, Kawabata Soya, Michikawa Takehiro, Nagai Sota, Takeda Hiroki, Ikeda Daiki, Kaneko Shinjiro, Fujita Nobuyuki
Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Department of Environmental and Occupational Health, School of Medicine, Toho University, Ota, Tokyo, Japan.
Fujita Med J. 2023 Aug;9(3):246-252. doi: 10.20407/fmj.2022-035. Epub 2023 May 9.
Although cervical spondylotic myelopathy (CSM) has a marked impact on locomotive function, few studies have evaluated this relationship in terms of locomotive syndrome. Thus, we assessed (i) the stages of locomotive syndrome in preoperative CSM patients using the 25-question geriatric locomotive function scale (GLFS-25), (ii) the correlation between GLFS-25 scores and the Japanese orthopaedic association (JOA) scores or the JOA cervical myelopathy evaluation questionnaire (JOACMEQ) scores, and (iii) the factors associated with stage 3 locomotive syndrome in preoperative CSM patients.
We used clinical data from 107 patients scheduled for cervical spinal surgery for CSM. Data were collected prior to surgery, and included age, gender, body mass index, medical history, JOA score, and JOACMEQ and GLFS-25 scores.
Of the included CSM patients, 93.5% were diagnosed with locomotive syndrome, of whom 77.6% were stage 3 according to GLFS-25 evaluation. For the correlation between GLFS-25 and JOA or JOACMEQ, the upper and lower extremity function scores of JOACMEQ and the JOA were strongly inversely correlated with the GLFS-25 score. Finally, multivariate analysis suggested that severe lower extremity status in the JOACMEQ was significantly associated with stage 3 locomotive syndrome in preoperative CSM patients.
Using the GLFS-25, we found that lower extremity status had the strongest association with stage 3 locomotive syndrome in preoperative CSM patients. These findings are useful for preventing CSM patients from requiring future nursing care.
尽管脊髓型颈椎病（CSM）对运动功能有显著影响，但很少有研究从运动综合征的角度评估这种关系。因此，我们评估了：（i）使用25个问题的老年运动功能量表（GLFS - 25）对术前CSM患者的运动综合征阶段；（ii）GLFS - 25评分与日本骨科协会（JOA）评分或JOA脊髓型颈椎病评估问卷（JOACMEQ）评分之间的相关性；以及（iii）术前CSM患者中与3期运动综合征相关的因素。
我们使用了107例计划接受CSM颈椎手术患者的临床数据。数据在手术前收集，包括年龄、性别、体重指数、病史、JOA评分以及JOACMEQ和GLFS - 25评分。
在所纳入的CSM患者中，93.5%被诊断为运动综合征，根据GLFS - 25评估，其中77.6%为3期。对于GLFS - 25与JOA或JOACMEQ之间的相关性，JOACMEQ和JOA的上肢和下肢功能评分与GLFS - 25评分呈强烈负相关。最后，多因素分析表明，JOACMEQ中严重的下肢状况与术前CSM患者的3期运动综合征显著相关。
使用GLFS - 25，我们发现下肢状况与术前CSM患者的3期运动综合征关联最强。这些发现有助于预防CSM患者未来需要护理。
