PMID- 38365668 OWN - NLM STAT- MEDLINE DCOM- 20240219 LR - 20240219 IS - 1471-2482 (Electronic) IS - 1471-2482 (Linking) VI - 24 IP - 1 DP - 2024 Feb 16 TI - Predictors of achieving minimal clinically important difference in functional status for elderly patients with degenerative lumbar spinal stenosis undergoing lumbar decompression and fusion surgery. PG - 59 LID - 10.1186/s12893-024-02356-9 [doi] LID - 59 AB - OBJECTIVE: To identify the predictors for the achievement of minimal clinically important difference (MCID) in functional status among elderly patients with degenerative lumbar spinal stenosis (DLSS) undergoing lumbar decompression and fusion surgery. METHODS: Patients who underwent lumbar surgery for DLSS and had a minimum of 1-year follow-up were included. The MCID achievement threshold for the Oswestry Disability Index (ODI) was set at 12.8. General patient information and the morphology of lumbar paraspinal muscles were evaluated using comparative analysis to identify influencing factors. Multiple regression models were employed to identify predictors associated with MCID achievement. A receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal cut-off values for predicting functional recovery. RESULTS: A total of 126 patients (46 males, 80 females; mean age 73.0 +/- 5.9 years) were included. The overall rate of MCID achievement was 74.6%. Patients who achieved MCID had significantly higher psoas major muscle attenuation (43.55 vs. 39.23, p < 0.001) and preoperative ODI (51.5 vs. 41.6, p < 0.001). Logistic regression showed that elevated psoas major muscle attenuation (p = 0.001) and high preoperative ODI scores (p = 0.001) were independent MCID predictors. The optimal cut-off values for predicting MCID achievement were found to be 40.46 Hounsfield Units for psoas major muscle attenuation and 48.14% for preoperative ODI. CONCLUSION: Preoperative psoas major muscle attenuation and preoperative ODI were reliable predictors of achieving MCID in geriatric patients undergoing lumbar decompression and fusion surgery. These findings offer valuable insights for predicting surgical outcomes and guiding clinical decision-making in elderly patients. CI - (c) 2024. The Author(s). FAU - Hou, Xiaofei AU - Hou X AD - Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. AD - Department of Orthopaedics, China National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China. FAU - Hu, Hailiang AU - Hu H AD - Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. FAU - Cui, Peng AU - Cui P AD - Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. FAU - Kong, Chao AU - Kong C AD - Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. AD - Department of Orthopaedics, China National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China. FAU - Wang, Wei AU - Wang W AD - Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. FAU - Lu, Shibao AU - Lu S AD - Department of Orthopaedics, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China. spinelsb@sina.com. AD - Department of Orthopaedics, China National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053, China. spinelsb@sina.com. LA - eng GR - KZ20231002537/The Joint Project of Beijing Municipal Education Commission and Beijing Natural Science Foundation/ GR - KZ20231002537/The Joint Project of Beijing Municipal Education Commission and Beijing Natural Science Foundation/ GR - KZ20231002537/The Joint Project of Beijing Municipal Education Commission and Beijing Natural Science Foundation/ GR - KZ20231002537/The Joint Project of Beijing Municipal Education Commission and Beijing Natural Science Foundation/ GR - KZ20231002537/The Joint Project of Beijing Municipal Education Commission and Beijing Natural Science Foundation/ GR - KZ20231002537/The Joint Project of Beijing Municipal Education Commission and Beijing Natural Science Foundation/ PT - Journal Article DEP - 20240216 PL - England TA - BMC Surg JT - BMC surgery JID - 100968567 SB - IM MH - Male MH - Female MH - Humans MH - Aged MH - Treatment Outcome MH - *Spinal Stenosis/surgery MH - Minimal Clinically Important Difference MH - Functional Status MH - *Spinal Fusion MH - Decompression MH - Lumbar Vertebrae/surgery MH - Retrospective Studies PMC - PMC10873985 OTO - NOTNLM OT - Degenerative lumbar spinal stenosis OT - Functional status OT - Minimal clinically important difference OT - Predictors COIS- The authors declare no competing interests. EDAT- 2024/02/17 10:43 MHDA- 2024/02/19 06:43 PMCR- 2024/02/16 CRDT- 2024/02/16 23:35 PHST- 2023/10/11 00:00 [received] PHST- 2024/02/10 00:00 [accepted] PHST- 2024/02/19 06:43 [medline] PHST- 2024/02/17 10:43 [pubmed] PHST- 2024/02/16 23:35 [entrez] PHST- 2024/02/16 00:00 [pmc-release] AID - 10.1186/s12893-024-02356-9 [pii] AID - 2356 [pii] AID - 10.1186/s12893-024-02356-9 [doi] PST - epublish SO - BMC Surg. 2024 Feb 16;24(1):59. doi: 10.1186/s12893-024-02356-9.