The impact of sarcopenia on the efficacy of posterior surgical treatment for degenerative lumbar scoliosis.

Abstract

Purpose: This study aimed to investigate the impact of sarcopenia on the clinical outcomes of patients undergoing posterior surgical treatment for degenerative lumbar scoliosis.

Methods: A retrospective analysis was conducted on clinical data from 76 patients with degenerative lumbar scoliosis, who meet the selection criteria between January 2019 and December 2023. The patients were categorized into a sarcopenia group (31 cases) and a non-sarcopenia group (45 cases) based on the diagnostic criteria of the European Working Group on Sarcopenia in Older People (EWGSOP). Operative time, intraoperative blood loss, hospital stay duration, incision length, incision healing time, and complications were compared between the sarcopenia and non-sarcopenia groups. The improvement in clinical symptoms was evaluated using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). To assess the scoliosis correction effect, measurements were taken for the coronal Cobb angle (CCA), C7 plumb line-center sacral vertical line (C7-CSVL), lumbar lordosis (LL), and C7 plumb line-sagittal vertical axis (C7-SVA).

Results: All patients successfully underwent the surgical procedure. The average operation time in the sarcopenia group was 256.27 ± 28.09 (180-350) min, which was not significantly different from the 249.82 ± 24.35(185-320) min in the non-sarcopenia group (p > 0.05). The average intraoperative blood loss in the sarcopenia group was 786.25 ± 38.19 (420-1365) mL, compared to 810.62 ± 45.47 (456-1780) mL in the non-sarcopenia group (p > 0.05). The average incision length in the sarcopenia group was 12.57 ± 1.29 (10-16)cm, compared to 12.83 ± 2.03 (9-20)cm in the non-sarcopenia group (p > 0.05). The incision healing time in the sarcopenia group required an average of 15.72 ± 1.74 (12-25)d, which longer than the 10.18 ± 1.05 (10-14 ) d in the non-sarcopenia group (p < 0.05). The average hospital stay in the sarcopenia group was 13.46 ± 1.37 (8-26) d, which was also longer than the 8.33 ± 0.92 (6-12)d in the non-sarcopenia group (p < 0.05). The complication rate in the sarcopenia group was 29.03% (9/31), which was higher than the 13.33% (6/45) in the non-sarcopenia group (p < 0.05). The VAS and ODI scores of both groups at the last follow-up were significantly improved compared to preoperative levels (p < 0.05). At the last follow-up, the ODI in the non-sarcopenia group was better than that in the sarcopenia group (p < 0.05). There was no statistically significant difference between the two groups in terms of VAS scores at the last follow-up (p > 0.05). Both groups demonstrated significant improvements in CCA, C7-CSVL, LL, and C7-SVA compared to preoperative levels (p < 0.05). However, no statistically significant differences were observed between the groups at the final follow-up (p > 0.05).

Conclusion: Sarcopenia does not significantly affect the radiological outcomes of patients with degenerative lumbar scoliosis undergoing posterior surgical procedures, ODI was better in the non-sarcopenia group. In addition, patients with sarcopenia typically require a longer postoperative recovery period and are more susceptible to various complications compared to those without sarcopenia.