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Review
. 2020 Aug 20;5(2):61-67.
doi: 10.22603/ssrr.2020-0112. eCollection 2021.

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

Nobuyuki Fujita  1
Affiliations
Review

Lumbar Spinal Canal Stenosis from the Perspective of Locomotive Syndrome and Metabolic Syndrome: A Narrative Review

Nobuyuki Fujita. Spine Surg Relat Res. .

Abstract

Patients with lumbar spinal canal stenosis (LSS) have impaired activities of daily living because of pain or motor paralysis, but no effective preventive treatment is currently available. The number of patients with LSS is predicted to continually increase as the average age of the global population increases. To provide a conceptual framework for improving healthy life expectancy, the Japanese Orthopaedic Association introduced the concept of locomotive syndrome, to which LSS is related. Ours and other studies have shown that LSS exacerbates locomotive syndrome and that surgical treatment is one method for improving it. Furthermore, we propose that the two-step test, a locomotive syndrome risk test, is effective for assessing the risk for falls and severity of LSS. Meanwhile, lumbar spinal epidural lipomatosis (LSEL), which is a manifestation of LSS, has been shown to be related to metabolic syndrome. Previous studies have suggested that the whole LSS can be also associated with metabolic syndrome. Although locomotive syndrome is very different from metabolic syndrome, which involves lipid metabolism, these two syndromes overlap, such as in LSS. Conducting research on LSS from the perspectives of both locomotive syndrome and metabolic syndrome may lead to novel methods for prevention and treatment of LSS and, conversely, may yield clues for resolving symptoms of the two syndromes. This review provides an overview of LSS from the perspective of locomotive syndrome and metabolic syndrome, along with findings from our research group.

Keywords: locomotive syndrome; lumbar spinal canal stenosis; metabolic syndrome.

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Conflict of interest statement

Conflicts of Interest: The author declares that there are no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
The two-step test (left panel) and timed up-and-go test (right panel).
Figure 2.
Figure 2.
Schematic model for the mechanisms of pain in patients with lumbar spinal epidural lipomatosis.
Figure 3.
Figure 3.
Schematic representation of ectopic fat. Excess accumulation of epidural fat can also be considered as a type of ectopic fat.
Figure 4.
Figure 4.
Lumbar spinal canal stenosis (LSS), which includes lumbar spinal epidural lipomatosis (LSEL), can be considered as an interaction between locomotive syndrome and metabolic syndrome.
See this image and copyright information in PMC

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