Andresen Andreas K, Carreon Leah Y, Andersen Mikkel Østerheden
Center for Spine Surgery and Research, Lillebaelt Hospital, Kolding, Denmark.
Institute of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, DK-5000, Odense C, Denmark.
Brain Spine. 2025 Apr 28;5:104265. doi: 10.1016/j.bas.2025.104265. eCollection 2025.
Although the pathognomonic symptom of patients with lumbar spinal stenosis is impaired walking tolerance, they may also have subclinical impairment of postural balance and urinary retention due to chronic compression of the cauda equina.
To investigate changes in postural balance and residual urine volume in patients with chronic lumbar spinal stenosis treated with decompression and fusion.
The current study is a prospective longitudinal observational cohort study. Patients scheduled for decompression and fusion due to LSS with spondylolisthesis ≤ grade I were enrolled. Patient reported outcome measures, Tandem test for balance and post-voiding bladder ultrasound was performed at baseline and at 3, 12 and 24 months postoperatively.
Among 100 patients included, 90 % had complete follow up data available. The majority (77 %) were female with a mean age of 70.6 years. 89 % of patients reported symptoms for more than six months prior to surgery. All patient reported outcome measures were significantly improved after surgery. Tandem test scores improved from 20.0 at baseline to 26.6 at three months follow up (p < 0.001) which was sustained at two years. Clinically relevant residual urine volume (≥100 mL) seen in 12 patients pre-operatively was absent at two-year follow-up.
Postural balance and post void residual urine, along with patient reported outcome measures, improved shortly after surgery, and the improvement was sustained two years after surgery. Physicians should consider using these two functional objective measures to evaluate disease severity and treatment effectiveness in patients with lumbar spinal stenosis.
虽然腰椎管狭窄症患者的典型症状是行走耐力受损，但由于马尾神经长期受压，他们也可能存在姿势平衡和尿潴留的亚临床损害。
探讨减压融合术治疗慢性腰椎管狭窄症患者的姿势平衡和残余尿量变化。
本研究是一项前瞻性纵向观察队列研究。纳入因腰椎滑脱≤I度的腰椎管狭窄症计划行减压融合术的患者。在基线以及术后3个月、12个月和24个月进行患者报告结局测量、平衡串联试验和排尿后膀胱超声检查。
纳入的100例患者中，90%有完整的随访数据。大多数（77%）为女性，平均年龄70.6岁。89%的患者在手术前症状持续超过6个月。所有患者报告的结局测量指标术后均有显著改善。串联试验评分从基线时的20.0提高到3个月随访时的26.6（p<0.001），并在两年时保持。术前12例患者出现的具有临床意义的残余尿量（≥100 mL）在两年随访时消失。
姿势平衡和排尿后残余尿量，以及患者报告的结局测量指标，在术后不久即得到改善，且改善持续至术后两年。医生应考虑使用这两项功能性客观指标来评估腰椎管狭窄症患者的疾病严重程度和治疗效果。
