Michael Jian-Wen Chen, Yuan-Shun Lo, Chia-Yu Lin, Chun Tseng, Pang-Hsuan Hsiao, Chien-Ying Lai, Ling-Yi Li, Hsien-Te Chen
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引用次数: 0
摘要
目的:本研究旨在整合有关肌肉疏松症对腰椎退行性手术预后影响的证据:使用 "肌肉疏松症 "和 "腰椎手术 "这两个关键词对公共数据库中截至 2023 年 11 月 15 日的文献进行检索。符合条件的研究均以接受腰椎退行性疾病减压或融合手术的成人为研究对象,并比较了术前患有和不患有肌肉疏松症的患者的治疗效果。主要研究结果为 ODI 和腰腿痛 VAS 疼痛评分的变化。次要结果是 Eq.5D、JOA、SFHS-p 评分和 LOS 的变化:最终,九项回顾性研究共纳入了 993 名患者。与非肌无力患者相比,肌无力患者通过 ODI 评估的功能改善情况明显较差(汇总标准化平均差 [pSMD] = 0.53,95% 置信区间 [CI]:0.17-0.90):0.17-0.90).背部疼痛(pSMD = 0.31,95% CI:0.15-0.47)和腿部疼痛(pSMD = 0.21,95% CI:0.02-0.39)在肌肉疏松患者中的改善程度也较低。非肌肉疏松患者在Eq.5D(pSMD = 0.25)和SFHS-p(pSMD = 0.39)方面的改善幅度更大,LOS(pSMD = 0.62)更短:结论:与无肌肉疏松症的患者相比,因退行性疾病接受腰椎手术的肌肉疏松症患者在功能能力、生活质量、身体健康、疼痛缓解和延长住院时间等方面的改善程度均低于无肌肉疏松症的患者。
Impact of sarcopenia on outcomes following lumbar spine surgery for degenerative disease: an updated systematic review and meta-analysis.
Purpose: This study aimed to consolidate the evidence regarding the prognostic influence of sarcopenia in degenerative lumbar spine surgeries.
Methods: A literature search of public databases was conducted up to Nov 15, 2023 using combinations of the key words "sarcopenia" and "lumbar spine surgery". Eligible studies were those that focused on adults undergoing decompression or fusion surgery for degenerative lumbar spine diseases, and compared the outcomes between patients with and without preoperative sarcopenia. Primary outcomes were change in ODI and back and leg pain VAS pain scores. Secondary outcomes were changes in Eq. 5D, JOA, SFHS-p scores, and LOS.
Results: Ultimately, nine retrospective studies with a total of 993 patients were included. Sarcopenic patients exhibited significantly worse functional improvement as assessed by ODI compared to non-sarcopenic patients (pooled standardized mean difference [pSMD] = 0.53, 95% confidence interval [CI]: 0.17-0.90). Back pain (pSMD = 0.31, 95% CI:0.15-0.47) and leg pain (pSMD = 0.21, 95% CI:0.02 - 0.39) improvement were also less in sarcopenic patients. Non-sarcopenic patients had greater improvements in Eq. 5D (pSMD = 0.25) and SFHS-p (pSMD = 0.39), and shorter LOS (pSMD = 0.62).
Conclusions: As compared to patients without sarcopenia, those with sarcopenia undergoing lumbar spine surgery for degenerative diseases have lower improvements in functional ability, quality of life, physical health, pain relief and extended hospitalization compared to those without sarcopenia.
期刊介绍:
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe