Lumbar spinal canal stenosis leads to locomotive syndrome in elderly patients

Fujita, Nobuyuki; Sakurai, Akira; Miyamoto, Azusa; Michikawa, Takehiro; Tsuji, Osahiko; Nagoshi, Narihito; Okada, Eijiro; Yagi, Mitsuru; Otaka, Yohei; Tsuji, Takashi; Kono, Hitoshi; Ishii, Ken; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota

doi:10.1016/j.jos.2018.08.004

Cited by 30 publications

(31 citation statements)

References 17 publications

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“…All 200 patients were diagnosed as having locomotive syndrome, and 97% of the patients were Stage 2. As LSS became more severe, their locomotive syndrome risk test scores worsened, demonstrating a correlation between the stage of locomotive syndrome and severity of LSS 21 ; this relationship was also observed by Kasukawa et al 22) and is consistent with the correlation between the 25-question GLFS and the Zurich Claudication Questionnaire reported by Araki et al 23) . We determined that among the locomotive syndrome risk tests, the two-step test is particularly strongly correlated with the severity of LSS 21 .…”

Section: Lumbar Spinal Canal Stenosis and Locomotive Syndromesupporting

confidence: 84%

“…As LSS became more severe, their locomotive syndrome risk test scores worsened, demonstrating a correlation between the stage of locomotive syndrome and severity of LSS 21 ; this relationship was also observed by Kasukawa et al 22) and is consistent with the correlation between the 25-question GLFS and the Zurich Claudication Questionnaire reported by Araki et al 23) . We determined that among the locomotive syndrome risk tests, the two-step test is particularly strongly correlated with the severity of LSS 21 . Importantly, we and others recently found that surgical treatment improves locomotive syndrome severity in patients with LSS 24,25) , with Shimizu et al noting that risk factors associated with non-improvement of neurological symptoms by surgical treatment were late elderly age and postoperative sagittal imbalance 25) .…”

Section: Lumbar Spinal Canal Stenosis and Locomotive Syndromesupporting

confidence: 84%

“…4). We and others have demonstrated that LSS was associated with locomotive syndrome and that surgical treatment for LSS was effective in decreasing the severity of locomotive syndrome [21][22][23][24][25] .…”

Section: Future Tasksmentioning

confidence: 89%

“…We previously performed locomotive syndrome risk tests for 200 patients aged ≥65 years with LSS who were scheduled to undergo surgery 21) . All 200 patients were diagnosed as having locomotive syndrome, and 97% of the patients were Stage 2.…”

Section: Lumbar Spinal Canal Stenosis and Locomotive Syndromementioning

confidence: 99%

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Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

Fujita

2021

Spine Surg Relat Res

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Patients with lumbar spinal canal stenosis (LSS) have impaired activities of daily living because of pain or motor paralysis, but no effective preventive treatment is currently available. The number of patients with LSS is predicted to continually increase as the average age of the global population increases. To provide a conceptual framework for improving healthy life expectancy, the Japanese Orthopaedic Association introduced the concept of locomotive syndrome, to which LSS is related. Ours and other studies have shown that LSS exacerbates locomotive syndrome and that surgical treatment is one method for improving it. Furthermore, we propose that the two-step test, a locomotive syndrome risk test, is effective for assessing the risk for falls and severity of LSS. Meanwhile, lumbar spinal epidural lipomatosis (LSEL), which is a manifestation of LSS, has been shown to be related to metabolic syndrome. Previous studies have suggested that the whole LSS can be also associated with metabolic syndrome. Although locomotive syndrome is very different from metabolic syndrome, which involves lipid metabolism, these two syndromes overlap, such as in LSS. Conducting research on LSS from the perspectives of both locomotive syndrome and metabolic syndrome may lead to novel methods for prevention and treatment of LSS and, conversely, may yield clues for resolving symptoms of the two syndromes. This review 2 provides an overview of LSS from the perspective of locomotive syndrome and metabolic syndrome, along with findings from our research group.

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Section: Lumbar Spinal Canal Stenosis and Locomotive Syndromesupporting

confidence: 84%

Section: Lumbar Spinal Canal Stenosis and Locomotive Syndromesupporting

confidence: 84%

Section: Future Tasksmentioning

confidence: 89%

Section: Lumbar Spinal Canal Stenosis and Locomotive Syndromementioning

confidence: 99%

See 2 more Smart Citations

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

Fujita

2021

Spine Surg Relat Res

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“…Especially, all patients in the knee group had total LS stage 2. These diseases are common in the elderly and closely associated with LS [ 9 , 11 , 18 ]. This study showed that almost all elderly patients requiring surgeries for these diseases had an advanced condition of LS stage 2.…”

Section: Discussionmentioning

confidence: 99%

Improvement of locomotive syndrome with surgical treatment in patients with degenerative diseases in the lumbar spine and lower extremities: a prospective cohort study

Kato

Kurokawa

Kabata

et al. 2020

BMC Musculoskelet Disord

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Background The epidemiology, risk factors, and prevention of locomotive syndrome (LS) have been reported. However, the number of clinical studies about the efficacy of LS treatment, including surgery, has been limited. This study aimed to evaluate LS and its improvement in patients undergoing surgeries for degenerative disease of the lumbar spine and lower extremities, and to discuss the effects of surgery on LS and the issues of LS assessment in these patients. Methods We enrolled 257 patients aged ≥60 years that underwent surgery for degenerative diseases of the lumbar spine and lower extremities and agreed to participate in the preoperative and 6- and 12-month postoperative LS examinations. According to the disease location, patients were divided into the lumbar ( n = 81), hip ( n = 106), knee ( n = 43), and foot and ankle ( n = 27) groups. Patients underwent LS risk tests, including the stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale (GLFS-25) assessment. Results The preoperative prevalence of LS stage 2 was 95%. Only the hip group showed significant improvements in the stand-up test. The knee group showed the worst results in the stand-up and two-step tests at all time points. All four groups had significant improvements in GLFS-25 scores. Approximately 40% of all patients had improvement in their LS stage postoperatively. However, > 90% of the patients in the knee group had LS stage 2 postoperatively. Conclusion Nearly all elderly patients requiring surgeries for degenerative diseases of the lumbar spine and lower extremities had advanced conditions (LS stage 2). Surgeries could be beneficial in alleviating LS. The LS stage 3 criteria should be established, and the use of the GLFS-25 assessment can be appropriate for advanced LS patients with severe musculoskeletal diseases requiring surgeries.

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Immunomodulatory activities and biomedical applications of melittin and its recent advances

Jafari,

Sadeghi,

Dehaghi

et al. 2024

Archiv der Pharmazie

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Melittin (MLT), a peptide containing 26 amino acids, is a key constituent of bee venom. It comprises ∼40%–60% of the venom's dry weight and is the main pricing index for bee venom, being the causative factor of pain. The unique properties of MLT extracted from bee venom have made it a very valuable active ingredient in the pharmaceutical industry as this cationic and amphipathic peptide has propitious effects on human health in diverse biological processes. It has the ability to strongly impact the membranes of cells and display hemolytic activity with anticancer characteristics. However, the clinical application of MLT has been limited by its severe hemolytic activity, which poses a challenge for therapeutic use. By employing more efficient mechanisms, such as modifying the MLT sequence, genetic engineering, and nano‐delivery systems, it is anticipated that the limitations posed by MLT can be overcome, thereby enabling its wider application in therapeutic contexts. This review has outlined recent advancements in MLT's nano‐delivery systems and genetically engineered cells expressing MLT and provided an overview of where the MLTMLT's platforms are and where they will go in the future with the challenges ahead. The focus is on exploring how these approaches can overcome the limitations associated with MLT's hemolytic activity and improve its selectivity and efficacy in targeting cancer cells. These advancements hold promise for the creation of innovative and enhanced therapeutic approaches based on MLT for the treatment of cancer.

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Lumbar spinal canal stenosis leads to locomotive syndrome in elderly patients

Cited by 30 publications

References 17 publications

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

Improvement of locomotive syndrome with surgical treatment in patients with degenerative diseases in the lumbar spine and lower extremities: a prospective cohort study

Immunomodulatory activities and biomedical applications of melittin and its recent advances

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