BMC Musculoskelet Disord. 2025 Oct 1;26(1):904. doi: 10.1186/s12891-025-09129-2.
ABSTRACT
BACKGROUND: Exploring the effect of sarcopenia on the clinical outcome of delta large-channel endoscopic treatment of elderly patients with lumbar spinal stenosis.
METHODS: Data were collected from 87 patients who underwent delta large-channel endoscopy between January 2022 and June 2023 at the First Affiliated Hospital of Ningbo University. Skeletal muscle index at the L3 level SMI < 36 cm2/m2 (males) and SMI < 29 cm2/m2 (females) were used as diagnostic thresholds for sarcopenia. We divided patients who met the inclusion criteria into a sarcopenia group (41) and a non-sarcopenia group (46). Patients’ age, gender, BMI, responsible segment, procedure-related parameters (intraoperative bleeding, operative time, hospitalization time, and complication occurrence), and clinical outcomes (Visual Analog Scale for Pain (VAS) scores, JOA scores, Oswestry Dysfunction Index (ODI) scores, and MacNab scores at the time of final follow-up) were recorded and compared.
RESULTS: There were no significant differences in gender, age, BMI, intraoperative bleeding, operative time, hospitalization time, and complication occurrence between the two groups (P > 0.05). Surgery was successfully completed in both groups. Clinical outcomes, such as lumbar VAS scores was not significant different between the two groups (P > 0.05). While comparing the lumbar VAS scores between the two groups at 6 months and 12 months postoperatively, the scores of the non- sarcopenia group were lower than those of the sarcopenia group, and the difference was statistically significant (P < 0.05). In addition, in the postoperative follow-up at 3 months, 6 months and 12 months, the comparison of ODI scores and JOA scores between the sarcopenia group and the non-sarcopenia group was statistically significant (P < 0.05), in which the ODI scores of the non-sarcopenia group were significantly lower than those of the sarcopenia group, and the JOA scores of the non-sarcopenia group were significantly higher than those of the sarcopenia group.
CONCLUSION: Functional recovery after delta large-channel endoscopic decompression was better in non-sarcopenia patients than in the sarcopenia group, and sarcopenia had a greater impact on long-term postoperative outcomes in older patients. We need to emphasize the diagnosis and intervention of sarcopenia in patients to reduce the impact of sarcopenia on postoperative clinical outcomes. Whether sarcopenia affects the stability of lumbar spine in endoscopic patients requires a longer follow-up period and later studies.
PMID:41034829 | DOI:10.1186/s12891-025-09129-2
