Surgical results in older patients with lumbar spinal stenosis according to gait speed in relation to the diagnosis for sarcopenia

Abstract

Purpose: The purpose of this study was to evaluate the implication of gait speed, which is a prerequisite for the diagnosis of sarcopenia in older patients with lumbar spinal stenosis (LSS). Methods: This study was conducted in a total of 235 patients with LSS who underwent surgical treatment. The state of sarcopenia and pre-sarcopenia, including gait speed, were evaluated before and after the operation. Results: The proportion of patients with lower than at baseline levels of skeletal muscle mass index (SMI) and gait speed was 27.2% and 17.9%, respectively. Significant changes were observed in gait speed, whereas SMI showed no significant differences between the preoperative and postoperative periods. Sarcopenic patients presented lower levels of activities of daily living preoperatively than pre-sarcopenic patients. However, favorable surgical results were obtained postoperatively. Significant changes were observed in gait speed, whereas grip strength and SMI showed no significant differences between the preoperative and postoperative periods. The postoperative decrease in SMI was not significant. Conclusion: Postoperative gait speed was significantly improved, whereas muscle mass did not increase in the patients in this study. Therefore, low gait speed in patients with LSS seems to be derived from a neurologic disorder. The surgical results in low muscle mass patients without low gait speed were similar to those with low gait speed. Sarcopenia in elderly patients with locomotor disease should be evaluated using muscle mass alone without assessing physical performance.