Severity of locomotive syndrome in surgical cervical spondylotic myelopathy patients: a cross-sectional study

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.