Chinese Medical Sciences Journal ›› 2023, Vol. 38 ›› Issue (2): 109-116.doi: 10.24920/004154
• Original Article • Previous Articles Next Articles
Yong Liu*(), Si-Yuan Yao, Xi Zhou, Shu-Zhong Liu, Yan-Yan Bian
Received:
2022-08-11
Accepted:
2023-01-13
Published:
2023-06-30
Online:
2023-04-04
Contact:
*86-10-69152200, E-mail: Yong Liu, Si-Yuan Yao, Xi Zhou, Shu-Zhong Liu, Yan-Yan Bian. Association Between Constipation and a Reduction in Lower Limb Muscle Strength in Preoperative Patients with Thoracic Spinal Tumors[J].Chinese Medical Sciences Journal, 2023, 38(2): 109-116.
Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks
Table 1.
Comparisons of demographic and clinical characteristics of patients between constipation and no-constipation patients"
Items | Constipation group (n=131) | No-constipation group (n=96) | Statistics | P value |
---|---|---|---|---|
Gender [n(%)] | χ2=0.094 | 0.759 | ||
Male | 75(57.3) | 53(55.2) | ||
Female | 56(42.7) | 43(44.8) | ||
Age (yrs, mean±SD) | 56.0±14.8 | 52.9±17.4 | t=1.445 | 0.150 |
Tumor type [n(%)] | ||||
Thoracic vertebral tumor | 17(13.0) | 11(11.5) | ||
Lymphoma | 5(3.8) | 5(5.2) | ||
Myoloma | 12(9.2) | 9(9.4) | ||
Metastasis | 97(74.0) | 71(74.0) | ||
Longitudinal location [n(%)] | χ2=0.541 | 0.763 | ||
Upper vertebra (T1-T4) | 38(29.0) | 32(33.3) | ||
Middle vertebra (T5-T8) | 52(39.7) | 37(38.5) | ||
Lower vertebra (T9-T12) | 41(31.3) | 27(28.1) | ||
Cross-sectional location [n(%)] | χ2=3.330 | 0.068 | ||
Dorsal side | 104(79.4) | 85(88.5) | ||
Ventral side | 27(20.6) | 11(11.5) | ||
Operation [n(%)] | χ2=1.130 | 0.568 | ||
Decompression with internal fixation | 81(61.8) | 53 (55.2) | ||
Tumor resection | 18(13.7) | 17(17.7) | ||
Pathological examination | 32(24.4) | 26(27.1) | ||
Onset symptom [n(%)] | χ2=8.602 | 0.055 | ||
Pain | 98(74.8) | 79(82.3) | ||
Paresthesia | 13(9.9) | 10(10.4) | ||
Paralysis | 15(11.5) | 3(3.1) | ||
Bowel/bladder dysfunction | 3(2.3) | 0 | ||
No symptom | 2(1.5) | 4(4.2) | ||
Symptom in progression [n(%)] | χ2=101.385 | <0.001 | ||
Pain | 17(13.0) | 57(59.4) | ||
Muscle weakness | 65(49.6) | 22(22.9) | ||
Paresthesia | 3(2.3) | 12(12.5) | ||
Bowel/bladder dysfunction | 46(35.1) | 1(1.0) | ||
No progress | 0 | 4(4.2) | ||
Duration of disease progress [d, median (interquartile range)] | 7.0(4.0,30.0) | 30.0(14.0,60.0) | Z=5.821 | 0.003 |
Urinary retention [n(%)] | χ2=83.536 | <0.001 | ||
Yes | 80(61.1) | 2(2.1) | ||
No | 51(38.9) | 94(97.9) | ||
Preoperative walking ability [n(%)] | χ2=99.035 | <0.001 | ||
Nomal | 22(16.8) | 79(82.3) | ||
Difficult | 22(16.8) | 8(8.3) | ||
Complete loss | 87(66.4) | 9(9.4) | ||
Frankel neurological function [n(%)] | χ2=154.878 | <0.001 | ||
A | 4(3.1) | 0 | ||
B | 19(14.5) | 2(2.1) | ||
C | 18(13.7) | 6(6.3) | ||
D1 | 45(34.4) | 5(5.2) | ||
D2 | 45(34.4) | 8(8.3) | ||
D3 | 0 | 75(78.1) | ||
E | 0 | 0 |
Table 2.
Univariate analysis of risk factors for muscle strength decline in patients with thoracic spinal tumors"
Variables | Muscle strength decline (n=126) | Nomal muscle strength (n=101) | Statistics | P value | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Constipation (n=109) | No constipation (n=17) | Statistics | P value | Constipation (n=22) | No constipation (n=79) | Statistics | P value | ||||
Gender [n(%)] | χ2=0.065 | 0.798 | χ2=1.943 | 0.163 | χ2=3.505 | 0.061 | |||||
Male | 67(61.5) | 11(64.7) | 8(36.4) | 42(53.2) | |||||||
Female | 42(38.5) | 6(35.3) | 14(63.6) | 37(46.8) | |||||||
Age (yrs, mean±SD) | 56.0±14.7 | 58.2±?6.8 | t=0.548 | 0.585 | 55.8±145.6 | 51.8±17.3 | t=0.967 | 0.336 | t=1.711 | 0.088 | |
Duration of disease progress [d, median (interquartile range)] | 7.0(4.0,15.0) | 14.0(7.0-30.0) | Z=1.904 | 0.057 | 30.0(14.3,60.0) | 30.0(20.0,60.0) | Z=0.674 | 0.518 | Z=7.714 | <0.001 | |
Urinary retention (with vs. without) [n(%)] | 76(69.7) vs. 33(30.3) | 2(11.8) vs. 15(88.2) | χ2=20.949 | <0.001 | 4(18.2) vs. 18(81.8) | 0 vs. 79(100) | χ2=14.956 | <0.001 | χ2=81.575 | <0.001 | |
Longitudinal location (upper vs. middle vs. lower)[n(%)] | 31(28.4) vs. 44(40.4) vs. 34(31.2) | 8(47.1) vs. 4(3.5) vs. 5(29.4) | χ2=2.757 | 0.252 | 7(31.8) vs. 8(36.4) vs. 7(31.8) | 24(30.4) vs. 33(41.8) vs. 22(27.8) | χ2=0.230 | 0.891 | χ2=0.184 | 0.912 | |
Cross-sectional location (ventral vs. dorsal)[n(%)] | 86(78.9) vs. 23(21.1) | 12(70.6) vs. 5(29.4) | χ2=0.588 | 0.443 | 18(81.8) vs. 4(18.2) | 73(92.4) vs. 6(7.6) | χ2=2.162 | 0.141 | χ2=6.106 | 0.013 |
Table 3.
Binary logistic regression analysis of risk factors for muscle strength decline in patients with thoracic spinal tumors"
Variables | Muscle strength decline (n=126) | Nomal muscle strength (n=101) | OR | 95%CI | P value |
---|---|---|---|---|---|
Gender (male vs. female) [n(%)] | 78(61.9) vs. 48(38.1) | 50(49.5) vs. 51(50.5) | 2.212 | 0.980-4.991 | 0.056 |
Age (yrs, mean±SD) | 56.29±15.05 | 52.68±16.93 | 1.007 | 0.983-1.030 | 0.584 |
Duration of progression [d, median (interquartile range)] | 14.0(3.0,60.0) | 15.0(7.0,60.0) | 1.000 | 0.998-1.003 | 0.721 |
Constipation (with vs. without) [n(%)] | 109(86.5) vs. 17(13.5) | 22(21.8) vs. 79(78.2) | 9.522 | 4.150-21.849 | <0.001 |
Urinary retention (with vs. without) [n(%)] | 78(61.9) vs. 48(38.1) | 4(4.0) vs. 97(96.0) | 14.490 | 4.543-46.213 | <0.001 |
Cross-sectional location (ventral vs. dorsal) [n(%)] | 98(77.8) vs. 28(22.2) | 91(90.1) vs. 10(9.9) | 2.693 | 0.919-7.896 | 0.071 |
1 |
Galgano M, Fridley J, Oyelese A, et al. Surgical management of spinal metastases. Expert Rev Anticancer Ther 2018 ; 18(5):463-72. doi: 10.1080/14737140.2018.1453359.
doi: 10.1080/14737140.2018.1453359 |
2 |
Lape EC, Katz JN, Blucher JA, et al. Patient experiences of decision-making in the treatment of spinal metastases: a qualitative study. Spine J 2020 ; 20(6):905-14. doi: 10.1016/j.spinee.2019.12.018.
doi: 10.1016/j.spinee.2019.12.018 |
3 |
Fan Y, Zhou X, Wang H, et al. The timing of surgical intervention in the treatment of complete motor paralysis in patients with spinal metastasis. Eur Spine J 2016 ; 25(12):4060-6. doi: 10.1007/s00586-016-4406-7.
doi: 10.1007/s00586-016-4406-7 |
4 |
Kawahara N, Tomita K, Murakami H, et al. Total en bloc spondylectomy of the lower lumbar spine: a surgical techniques of combined posterior-anterior approach. Spine (Phila Pa 1976) 2011 ; 36(1):74-82. doi: 10.1097/BRS.0b013e3181cded6c.
doi: 10.1097/BRS.0b013e3181cded6c |
5 |
Bellini M, Tonarelli S, Barracca F, et al. Chronic constipation: is a nutritional approach reasonable? Nutrients 2021 ; 13(10):3386. doi: 10.3390/nu13103386.
doi: 10.3390/nu13103386 |
6 |
Patil SS, Nene AM. Total enbloc spondylectomy for metastatic high grade spinal tumors: early results. Indian J Orthop 2016 ; 50(4):352-8. doi: 10.4103/0019-5413.185589.
doi: 10.4103/0019-5413.185589 |
7 | Bradford DS, McBride GG. Surgical management of thoracolumbar spine fractures with incomplete neurologic deficits. Clin Orthop Relat Res 1987; (218):201-16. |
8 |
Takeshita S, Todo Y, Okamoto K, et al. Thoracic laminectomy with spinal fixation in a nonambulatory patient with metastatic vertebral tumor from endometrial carcinoma. J Obstet Gynaecol Res 2016 ; 42(10):1395-9. doi: 10.1111/jog.13054.
doi: 10.1111/jog.13054 |
9 |
Cardia A, Cannizzaro D, Stefini R, et al. The efficacy of laser interstitial thermal therapy in the management of spinal metastases: a systematic review of the literature. Neurol Sci 2023 ; 44(2):519-28. doi: 10.1007/s10072-022-06432-x.
doi: 10.1007/s10072-022-06432-x |
10 |
Morgen SS, Fruergaard S, Gehrchen M, et al. A revision of the Tokuhashi revised score improves the prognostic ability in patients with metastatic spinal cord compression. J Cancer Res Clin Oncol 2018 ; 144(1):33-8. doi: 10.1007/s00432-017-2519-y.
doi: 10.1007/s00432-017-2519-y |
11 |
Gruenberg M, Mereles ME, Willhuber GOC, et al. Usefulness of Tokuhashi score in survival prediction of patients operated for vertebral metastatic disease. Global Spine J 2017 ; 7(3):260-5. doi: 10.1177/2192568217699186.
doi: 10.1177/2192568217699186 |
12 |
Brading AF, Ramalingam T. Mechanisms controlling normal defecation and the potential effects of spinal cord injury. Prog Brain Res 2006; 152:345-58. doi: 10.1016/S0079-6123(05)52023-5.
doi: 10.1016/S0079-6123(05)52023-5 pmid: 16198712 |
13 |
Vizzard MA, Brisson M, de Groat WC. Transneuronal labeling of neurons in the adult rat central nervous system following inoculation of pseudorabies virus into the colon. Cell Tissue Res 2000 ; 299(1):9-26. doi: 10.1007/s004419900128.
doi: 10.1007/s004419900128 |
14 |
Wong K, Boone TB, Wong ST, et al. Functional brain interactions during reflexive micturition are absent from spinal cord injured rats with neurogenic bladder. Neurourol Urodyn 2015 ; 34(5):469-74. doi: 10.1002/nau.22596.
doi: 10.1002/nau.22596 |
15 |
Pavcovich LA, Yang M, Miselis RR, et al. Novel role for the pontine micturition center, Barrington’s nucleus: evidence for coordination of colonic and forebrain activity. Brain Res 1998 ; 784(1-2):355-61. doi: 10.1016/s0006-8993(97)01178-5.
doi: 10.1016/s0006-8993(97)01178-5 |
16 |
Rouzade-Dominguez ML, Miselis R, Valentino RJ. Central representation of bladder and colon revealed by dual transsynaptic tracing in the rat: substrates for pelvic visceral coordination. Eur J Neurosci 2003 ; 18(12):3311-24. doi: 10.1111/j.1460-9568.20.
doi: 10.1111/j.1460-9568.20 |
[1] | Jin Wen, Han-zhong Li*, Zhi-gang Ji, and Hong-jun Li . Immediate Surgical Intervention for Penile Fracture: a Case Report and Literature Review [J]. Chinese Medical Sciences Journal, 2011, 26(2): 132-134. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||
|
Supervised by National Health Commission of the People's Republic of China
9 Dongdan Santiao, Dongcheng district, Beijing, 100730 China
Tel: 86-10-65105897 Fax:86-10-65133074
E-mail: cmsj@cams.cn www.cmsj.cams.cn
Copyright © 2018 Chinese Academy of Medical Sciences
All right reserved.
京公安备110402430088 京ICP备06002729号-1