Sakaguchi Tomoyoshi, Tanaka Masato, Arataki Shinya, Komatsubara Tadashi, Miyamoto Akiyoshi, Borde Mandar, Arvind Umarani, Takamatsu Kazuhiko, Yasuda Yosuke, Doană-Prodan Adrian, Ishihara Kaoruko
Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikko Midorimachi, Minami-ku, Okayama 702-8055, Japan.
Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan.
J Clin Med. 2025 Aug 5;14(15):5520. doi: 10.3390/jcm14155520.
Prospective observational study. Lumbar spinal stenosis (LSS) impairs balance and gait function, increasing fall risk and limiting quality of life. Although postoperative recovery of balance is clinically important, longitudinal data using multidimensional balance assessments are limited. A prospective cohort study was conducted in 101 patients (mean age 74.9 ± 6.9 years) undergoing surgery for LSS. The Brief Balance Evaluation Systems Test (Brief BESTest), Oswestry Disability Index (ODI), Modified Falls Efficacy Scale (MFES), Zurich Claudication Questionnaire (ZCQ), and Visual Analog Scales (VAS) for pain/numbness were evaluated preoperatively and at 6 and 12 months postoperatively. Changes over time and correlations between Brief BESTest and PROMs were analyzed. The total Brief BESTest score significantly improved from 13.3 ± 5.3 preoperatively to 16.1 ± 5.1 at 6 months and 16.0 ± 5.1 at 12 months ( < 0.01). Subdomains including Anticipatory Adjustments, Postural Responses, Sensory Orientation, and Stability in Gait improved significantly, while Stability Limits did not. At 12 months postoperatively, ODI decreased by 19.1%, ZCQ symptom and function scores improved by 0.8 and 0.9 points, respectively, and VAS scores improved by 17.1 mm for low back pain, 26.5 mm for lower limb pain, and 19.5 mm for numbness, all showing marked improvements from baseline. MFES also increased significantly postoperatively. The Brief BESTest score correlated significantly with MFES and ZCQ-PFS at baseline, and with ODI, ZCQ, and VAS scores at 12 months. Balance ability in LSS patients improved after surgery, as measured by the Brief BESTest, with clinically meaningful changes maintained for 12 months. Improvements in balance were significantly associated with reductions in pain, disability, and fear of falling, suggesting the Brief BESTest is a comprehensive indicator of postoperative recovery.
前瞻性观察性研究。腰椎管狭窄症（LSS）会损害平衡和步态功能，增加跌倒风险并限制生活质量。尽管术后平衡功能的恢复在临床上很重要，但使用多维平衡评估的纵向数据有限。对101例接受LSS手术的患者（平均年龄74.9±6.9岁）进行了一项前瞻性队列研究。术前以及术后6个月和12个月评估了简易平衡评估系统测试（Brief BESTest）、Oswestry功能障碍指数（ODI）、改良跌倒效能量表（MFES）、苏黎世跛行问卷（ZCQ）以及疼痛/麻木的视觉模拟量表（VAS）。分析了随时间的变化以及Brief BESTest与患者报告结局量表（PROMs）之间的相关性。Brief BESTest总分从术前的13.3±5.3显著提高到术后6个月的16.1±5.1以及术后12个月的16.0±5.1（<0.01）。包括预期调整、姿势反应、感觉定向和步态稳定性在内的子领域有显著改善，而稳定性极限没有改善。术后12个月时，ODI下降了19.1%，ZCQ症状和功能评分分别提高了0.8分和0.9分，VAS评分中，下腰痛改善了17.1mm，下肢疼痛改善了26.5mm，麻木改善了19.5mm，均较基线有显著改善。术后MFES也显著增加。Brief BESTest评分在基线时与MFES和ZCQ - PFS显著相关，在术后12个月时与ODI、ZCQ和VAS评分显著相关。通过Brief BESTest测量，LSS患者术后平衡能力得到改善，且有临床意义的变化持续了12个月。平衡能力的改善与疼痛、残疾和跌倒恐惧的减轻显著相关，这表明Brief BESTest是术后恢复的一个综合指标。
