European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
Preoperative impairment of the joint position sense in the big toe is a risk factor for delayed recovery of mobility after lumbar spinal stenosis surgery.
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Maeda Takuya, Nanri Yuta, Nozaki Kohei, Masuma Hiroyoshi, Nihei Manami, Uchiya Takako, Kawabata Masashi, Inoue Gen, Nakazawa Toshiyuki, Imura Takayuki, Miyagi Masayuki, Mimura Yusuke, Tanaka Yoshihide, Yokozeki Yuji, Takaso Masashi
Аннотация
PURPOSE: To clarify the relationship between early postoperative recovery of mobility and preoperative impairment of the joint position sense in the big toe in patients with lumbar spinal stenosis (LSS).
METHODS: The subjects were 247 patients who underwent surgery for LSS. The main outcome was recovery of early postoperative mobility defined as the availability of walking independence after surgery (Barthel index = 15) and the number of days from surgery to starting to walk independently. Preoperative physical functions such as the joint position sense, surgical information and clinical characteristics were measured and analyzed. The relationship between early postoperative recovery of mobility and preoperative impairment of the joint position sense in the big toe was examined using log-rank tests and Cox proportional hazards models.
RESULTS: Impairment of the position sense was observed in 51 patients. Patients with impairment of the position sense had a lower rate of early recovery of mobilization compared with non-impaired patients (63% vs. 89%, p < 0.01). According to the Kaplan-Meier curves, patients with impairment of the position sense had a significant delay in mobilization compared with those who were not impaired (p < 0.01). The hazard ratio for delayed recovery of mobility was 0.54 (95% confidence interval 0.36-0.79).
CONCLUSION: Preoperative impairment of the joint position sense in the big toe was a risk factor for prolonged recovery of mobility in the early postoperative period in patients after LSS surgery.
METHODS: The subjects were 247 patients who underwent surgery for LSS. The main outcome was recovery of early postoperative mobility defined as the availability of walking independence after surgery (Barthel index = 15) and the number of days from surgery to starting to walk independently. Preoperative physical functions such as the joint position sense, surgical information and clinical characteristics were measured and analyzed. The relationship between early postoperative recovery of mobility and preoperative impairment of the joint position sense in the big toe was examined using log-rank tests and Cox proportional hazards models.
RESULTS: Impairment of the position sense was observed in 51 patients. Patients with impairment of the position sense had a lower rate of early recovery of mobilization compared with non-impaired patients (63% vs. 89%, p < 0.01). According to the Kaplan-Meier curves, patients with impairment of the position sense had a significant delay in mobilization compared with those who were not impaired (p < 0.01). The hazard ratio for delayed recovery of mobility was 0.54 (95% confidence interval 0.36-0.79).
CONCLUSION: Preoperative impairment of the joint position sense in the big toe was a risk factor for prolonged recovery of mobility in the early postoperative period in patients after LSS surgery.