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Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity

Study Design: Retrospective observational study. Background: The risk of a femoral neck fracture due to a fall after adult spinal deformity surgery has been reported. One of the most significant factors among walking and balance tests in post-operative ASD patients was the timed up-and-go test (TUG)...

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Autores principales: Sakaguchi, Tomoyoshi, Meena, Umesh, Tanaka, Masato, Xiang, Hongfei, Fujiwara, Yoshihiro, Arataki, Shinya, Taoka, Takuya, Takamatsu, Kazuhiko, Yasuda, Yosuke, Nakagawa, Masami, Utsunomiya, Kayo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607759/
https://www.ncbi.nlm.nih.gov/pubmed/37892638
http://dx.doi.org/10.3390/jcm12206500
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author Sakaguchi, Tomoyoshi
Meena, Umesh
Tanaka, Masato
Xiang, Hongfei
Fujiwara, Yoshihiro
Arataki, Shinya
Taoka, Takuya
Takamatsu, Kazuhiko
Yasuda, Yosuke
Nakagawa, Masami
Utsunomiya, Kayo
author_facet Sakaguchi, Tomoyoshi
Meena, Umesh
Tanaka, Masato
Xiang, Hongfei
Fujiwara, Yoshihiro
Arataki, Shinya
Taoka, Takuya
Takamatsu, Kazuhiko
Yasuda, Yosuke
Nakagawa, Masami
Utsunomiya, Kayo
author_sort Sakaguchi, Tomoyoshi
collection PubMed
description Study Design: Retrospective observational study. Background: The risk of a femoral neck fracture due to a fall after adult spinal deformity surgery has been reported. One of the most significant factors among walking and balance tests in post-operative ASD patients was the timed up-and-go test (TUG). This study aims to calculate the minimal clinically important difference (MCID) in balance tests after ASD surgery. Methods: Forty-eight patients, 4 males and 44 females, were included by exclusion criteria in 66 consecutive patients who underwent corrective surgery as a treatment for ASD at our institution from June 2017 to February 2022. The inclusion criteria for this study were age ≥50 years; and no history of high-energy trauma. The exclusion criteria were dementia, severe deformity of the lower extremities, severe knee or hip osteoarthritis, history of central nervous system disorders, cancer, and motor severe paralysis leading to gait disorders. The surgeries were performed in two stages, first, the oblique lumber interbody fusion (OLIF) L1 to L5 (or S1), and second, the posterior corrective fusion basically from T10 to pelvis. For outcome assessment, 10 m walk velocity, TUG, ODI, and spinopelvic parameters were used. Results: Ten meter walk velocity of pre-operation and post-operation were 1.0 ± 0.3 m/s and 1.2 ± 0.2 m/s, respectively (p < 0.01). The TUG of pre-operation and post-operation were 12.1 ± 3.7 s and 9.7 ± 2.2 s, respectively (p < 0.01). The ODI improved from 38.6 ± 12.8% to 24.2 ± 15.9% after surgery (p < 0.01). All post-operative parameters except PI obtained statistically significant improvement after surgery. Conclusions: This is the first report of MCID of the 10 m walk velocity and TUG after ASD surgery. Ten meter walk velocity and the TUG improved after surgery; their improvement values were correlated with the ODI. MCID using the anchor-based approach for 10 m walk velocity and the TUG were 0.10 m/s and 2.0 s, respectively. These MCID values may be useful for rehabilitation after ASD surgery.
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spelling pubmed-106077592023-10-28 Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity Sakaguchi, Tomoyoshi Meena, Umesh Tanaka, Masato Xiang, Hongfei Fujiwara, Yoshihiro Arataki, Shinya Taoka, Takuya Takamatsu, Kazuhiko Yasuda, Yosuke Nakagawa, Masami Utsunomiya, Kayo J Clin Med Article Study Design: Retrospective observational study. Background: The risk of a femoral neck fracture due to a fall after adult spinal deformity surgery has been reported. One of the most significant factors among walking and balance tests in post-operative ASD patients was the timed up-and-go test (TUG). This study aims to calculate the minimal clinically important difference (MCID) in balance tests after ASD surgery. Methods: Forty-eight patients, 4 males and 44 females, were included by exclusion criteria in 66 consecutive patients who underwent corrective surgery as a treatment for ASD at our institution from June 2017 to February 2022. The inclusion criteria for this study were age ≥50 years; and no history of high-energy trauma. The exclusion criteria were dementia, severe deformity of the lower extremities, severe knee or hip osteoarthritis, history of central nervous system disorders, cancer, and motor severe paralysis leading to gait disorders. The surgeries were performed in two stages, first, the oblique lumber interbody fusion (OLIF) L1 to L5 (or S1), and second, the posterior corrective fusion basically from T10 to pelvis. For outcome assessment, 10 m walk velocity, TUG, ODI, and spinopelvic parameters were used. Results: Ten meter walk velocity of pre-operation and post-operation were 1.0 ± 0.3 m/s and 1.2 ± 0.2 m/s, respectively (p < 0.01). The TUG of pre-operation and post-operation were 12.1 ± 3.7 s and 9.7 ± 2.2 s, respectively (p < 0.01). The ODI improved from 38.6 ± 12.8% to 24.2 ± 15.9% after surgery (p < 0.01). All post-operative parameters except PI obtained statistically significant improvement after surgery. Conclusions: This is the first report of MCID of the 10 m walk velocity and TUG after ASD surgery. Ten meter walk velocity and the TUG improved after surgery; their improvement values were correlated with the ODI. MCID using the anchor-based approach for 10 m walk velocity and the TUG were 0.10 m/s and 2.0 s, respectively. These MCID values may be useful for rehabilitation after ASD surgery. MDPI 2023-10-12 /pmc/articles/PMC10607759/ /pubmed/37892638 http://dx.doi.org/10.3390/jcm12206500 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sakaguchi, Tomoyoshi
Meena, Umesh
Tanaka, Masato
Xiang, Hongfei
Fujiwara, Yoshihiro
Arataki, Shinya
Taoka, Takuya
Takamatsu, Kazuhiko
Yasuda, Yosuke
Nakagawa, Masami
Utsunomiya, Kayo
Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity
title Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity
title_full Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity
title_fullStr Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity
title_full_unstemmed Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity
title_short Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity
title_sort minimal clinically important differences in gait and balance ability in patients who underwent corrective long spinal fusion for adult spinal deformity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607759/
https://www.ncbi.nlm.nih.gov/pubmed/37892638
http://dx.doi.org/10.3390/jcm12206500
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