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Predictors of achieving minimal clinically important difference in functional status for elderly patients with degenerative lumbar spinal stenosis undergoing lumbar decompression and fusion surgery

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机构： [1]Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. [2]Department of Orthopaedics, China National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China.

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关键词： Degenerative lumbar spinal stenosis Functional status Minimal clinically important difference Predictors

摘要：

To identify the predictors for the achievement of minimal clinically important difference (MCID) in functional status among elderly patients with degenerative lumbar spinal stenosis (DLSS) undergoing lumbar decompression and fusion surgery.Patients who underwent lumbar surgery for DLSS and had a minimum of 1-year follow-up were included. The MCID achievement threshold for the Oswestry Disability Index (ODI) was set at 12.8. General patient information and the morphology of lumbar paraspinal muscles were evaluated using comparative analysis to identify influencing factors. Multiple regression models were employed to identify predictors associated with MCID achievement. A receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal cut-off values for predicting functional recovery.A total of 126 patients (46 males, 80 females; mean age 73.0 ± 5.9 years) were included. The overall rate of MCID achievement was 74.6%. Patients who achieved MCID had significantly higher psoas major muscle attenuation (43.55 vs. 39.23, p < 0.001) and preoperative ODI (51.5 vs. 41.6, p < 0.001). Logistic regression showed that elevated psoas major muscle attenuation (p = 0.001) and high preoperative ODI scores (p = 0.001) were independent MCID predictors. The optimal cut-off values for predicting MCID achievement were found to be 40.46 Hounsfield Units for psoas major muscle attenuation and 48.14% for preoperative ODI.Preoperative psoas major muscle attenuation and preoperative ODI were reliable predictors of achieving MCID in geriatric patients undergoing lumbar decompression and fusion surgery. These findings offer valuable insights for predicting surgical outcomes and guiding clinical decision-making in elderly patients.© 2024. The Author(s).

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出版当年[2023]版：

大类 | 3 区医学

小类 | 3 区外科

最新[2023]版：

大类 | 3 区医学

小类 | 3 区外科

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出版当年[2022]版：

Q3 SURGERY

最新[2023]版：

Q2 SURGERY

影响因子： 1.6 最新[2023版] 1.9 最新五年平均 1.9 出版当年[2022版] 2.2 出版当年五年平均 2.03 出版前一年[2021版] 1.6 出版后一年[2023版]

第一作者：

第一作者机构： [1]Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. [2]Department of Orthopaedics, China National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China.

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通讯作者：

通讯机构： [1]Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. [2]Department of Orthopaedics, China National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China.

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Predictors of achieving minimal clinically important difference in functional status for elderly patients with degenerative lumbar spinal stenosis undergoing lumbar decompression and fusion surgery

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