Bone Abstracts

Study design: Prospective study.

Objectives: The risk factors correlated with actual falls were assessed in patients with lumbar spinal stenosis.

Materials and methods: In 201 patients (M:F 65:136) with symptomatic lumbar spinal stenosis, falls history within recent one year was investigated. The factors which were expected correlation with actual falls were evaluated together. Blood chemistry was performed to evaluate serum Vitamin D level and the nutritional marker (transferrin, albumin) and hemoglobin level. Oswestry Disability Index (ODI) and EQ5D-VAS score also were investigated. Handgrip strength was measured as the muscle strength using dynamometer. And knee osteoarthritis as comorbidities were examined using the Kellgren-Lawrence Grading Scale. Falls were assessed to occur if there is more than two times within recent one year. Patients were divided two groups; Group A (Actual falls ≧2), Group B (Actual falls ≤1). Univariate analysis following logistic regression analysis were performed to derive risk factors with actual falls.

Results: Average age of patients was 70.7. Actual falls occurred 36 patients in total 201 patients (18.0%). In univariate analysis, serum vitamin D level, transferrin level, ODI, EQ5D-VAS, hand grip strength, and knee osteoarthritis with Kellgren-Lawrence grade scale showed statically significant differences between two groups. (P<0.05) For these factors, logistic regression was done to find out risk factors related with actual falls. Serum vitamin D level (P-value 0.01, odds ratio 0.89) and hand grip strength (P-value 0.003 odds ratio 0.83) were revealed as risk factors of actual falls.

Conclusion: In patients with lumbar spinal stenosis over 60 years old, serum Vitamin D level and handgrip strength are associated with actual falls. Patients with weaker handgrip strength and lower serum vitamin D level tend to fall more frequently.