The critical cutoff point of the Zurich Claudication Questionnaire and the Japanese Orthopaedic Association score indicating locomotive syndrome in patients with lumbar spinal canal stenosis.


Journal

Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
ISSN: 1436-2023
Titre abrégé: J Orthop Sci
Pays: Japan
ID NLM: 9604934

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 01 12 2019
revised: 03 02 2020
accepted: 24 02 2020
pubmed: 8 4 2020
medline: 23 9 2021
entrez: 8 4 2020
Statut: ppublish

Résumé

Locomotive syndrome (LS) is a condition of decreased mobility caused by disorders of the locomotive organs. Lumbar spinal stenosis (LSS) is a LS disorder. The Japanese Orthopaedic Association score (JOA score) and the Zurich Claudication Questionnaire (ZCQ) are international evaluation tools for LSS. However, the relationship between LS and JOA score or ZCQ is unknown. This study aimed to clarify the correlations between LS progression and the values/parameters of the JOA score or ZCQ and to determine the critical cutoff point of the JOA score or ZCQ that indicates LS progression. We recruited preoperative LSS patients (n = 82). Patients' mean age was 73.4 years. The study participants were evaluated using the 25-question Geriatric Locomotive Function Scale (GLFS), JOA score, and ZCQ (which consists of symptom severity and physical function), and the patients' health-related quality of life was assessed using EuroQoL-5 dimension (EQ-5D) utility values and the EuroQoL-visual analog scale (EQ-VAS). We investigated the correlations between the 25-question GLFS and each clinical variable and evaluated the critical cutoff point of each international evaluation tool to detect LS. There was a statistically significant correlation between 25-question GLFS and each clinical evaluation tool. LSS patients with LS showed significantly worse scores in the evaluation tools than LSS patients without LS. Moreover, we found that critical cutoff points of 17.5 on JOA score, 3.1 on ZCQ-symptom, and 2.3 on ZCQ-function could detect LS. A statistically significant correlation exists between the 25-question GLFS and the JOA score or ZCQ. It might be important to perform decompression surgery for LSS patients before they reach the cutoff values of the several clinical evaluation tools to avoid LS progression. Clinical prospective case-control study.

Sections du résumé

BACKGROUND BACKGROUND
Locomotive syndrome (LS) is a condition of decreased mobility caused by disorders of the locomotive organs. Lumbar spinal stenosis (LSS) is a LS disorder. The Japanese Orthopaedic Association score (JOA score) and the Zurich Claudication Questionnaire (ZCQ) are international evaluation tools for LSS. However, the relationship between LS and JOA score or ZCQ is unknown. This study aimed to clarify the correlations between LS progression and the values/parameters of the JOA score or ZCQ and to determine the critical cutoff point of the JOA score or ZCQ that indicates LS progression.
METHODS METHODS
We recruited preoperative LSS patients (n = 82). Patients' mean age was 73.4 years. The study participants were evaluated using the 25-question Geriatric Locomotive Function Scale (GLFS), JOA score, and ZCQ (which consists of symptom severity and physical function), and the patients' health-related quality of life was assessed using EuroQoL-5 dimension (EQ-5D) utility values and the EuroQoL-visual analog scale (EQ-VAS). We investigated the correlations between the 25-question GLFS and each clinical variable and evaluated the critical cutoff point of each international evaluation tool to detect LS.
RESULTS RESULTS
There was a statistically significant correlation between 25-question GLFS and each clinical evaluation tool. LSS patients with LS showed significantly worse scores in the evaluation tools than LSS patients without LS. Moreover, we found that critical cutoff points of 17.5 on JOA score, 3.1 on ZCQ-symptom, and 2.3 on ZCQ-function could detect LS.
CONCLUSIONS CONCLUSIONS
A statistically significant correlation exists between the 25-question GLFS and the JOA score or ZCQ. It might be important to perform decompression surgery for LSS patients before they reach the cutoff values of the several clinical evaluation tools to avoid LS progression.
STUDY DESIGN METHODS
Clinical prospective case-control study.

Identifiants

pubmed: 32253080
pii: S0949-2658(20)30071-3
doi: 10.1016/j.jos.2020.02.019
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

290-294

Informations de copyright

Copyright © 2020 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None declared.

Auteurs

Masafumi Araki (M)

Department of Orthopaedic Surgery, Saiseikai Tondabayashi Hospital, 1-3-36 Koyodai Tondabayashi City, Osaka, 5840082, Japan.

Hiroshi Nonoshita (H)

Department of Orthopaedic Surgery, Saiseikai Tondabayashi Hospital, 1-3-36 Koyodai Tondabayashi City, Osaka, 5840082, Japan.

Shuji Kitano (S)

Department of Orthopaedic Surgery, Saiseikai Tondabayashi Hospital, 1-3-36 Koyodai Tondabayashi City, Osaka, 5840082, Japan.

Hideki Shigematsu (H)

Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan. Electronic address: shideki714@gmail.com.

Masato Tanaka (M)

Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan.

Sachiko Kawasaki (S)

Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan.

Yuma Suga (Y)

Department of Orthopaedic Surgery, Saiseikai Tondabayashi Hospital, 1-3-36 Koyodai Tondabayashi City, Osaka, 5840082, Japan.

Yusuke Yamamoto (Y)

Department of Orthopaedic Surgery, Saiseikai Tondabayashi Hospital, 1-3-36 Koyodai Tondabayashi City, Osaka, 5840082, Japan.

Yasuhito Tanaka (Y)

Department of Orthopaedic Surgery, Saiseikai Tondabayashi Hospital, 1-3-36 Koyodai Tondabayashi City, Osaka, 5840082, Japan.

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