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RELATIONSHIP BETWEEN BONY SPINAL CANAL STENOSIS AND THE OCCURRENCE OF CLINICAL SYMPTOMS OF LUMBAR SPINAL STENOSIS — THE WAKAYAMA SPINE STUDY: O14

Iwahashi, Hiroki; Yoshimura, Noriko; Hashizume, Hiroshi; Yamada, Hiroshi; Oka, Hirioyuki; Shinto, Kazunori; Ishimoto, Yuyu; Nagata, Keiji; Teraguchi, Masatoshi; Kagotani, Ryohei; Muraki, Shigeyuki; Minamide, Akihito; Nakagawa, Yukihiro; Yoshida, Munehito

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Spine Journal Meeting Abstracts: 2015 - Volume 2015 - Issue - p 50
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INTRODUCTION: For the lumbar spine, compared with the cervical spine, the importance of the size and shape of the spinal canal in relation to the occurrence of symptoms of lumbar spinal stenosis (LSS) is not clear.The aim of this study was to investigate the age‐ and sex‐related changes in parameters of bony stenosis of the lumbar spine and the relationship of these changes to clinical symptoms of LSS. METHODS:This cross‐sectional study included 797 participants (240 men and 557 women;mean age, 63.6 years) of the second follow‐up of the Wakayama Spine Study, which used a population‐based cohort.Spinal stenosis parameters were measured on axial (upper margin of the pedicle level) T2‐weighted MRI.Measurements included the antero‐posterior bony spinal canal diameter (APSD) (L2‐5).We used a multivariable logistic regression model to investigate the relationship between the occurrence of buttock and leg pains as an objective variable and APSD as an explanatory variable after adjustment for age group, sex, and body mass index category.P‐values less than 0.05 were considered as statistically significant. RESULTS:The APSD (mean±SD, mm) were as follows:L2,23.1±2.1;L3,22.7±2.4;L4,21.6±2.7; L5, 18.8±2.9. The lower lumbar spine had a narrower APSD. The men had significantly wider APSD at the L4 level than the women.The APSD at the L4 level became narrower with age.The multivariate logistic regression model revealed that the APSD at the L4 level was significantly related to the occurrence of buttock and leg pains. DISCUSSION:This is the first study to report age‐ and sex‐related changes in parameters of bony stenosis of the lumbar spine and their relationship to the occurrence of clinical symptoms of LSS in a population‐based cohort. The APSD at the L4 level was significantly related to the occurrence of buttock and leg pains, whereas those at the other levels were not. Other factors (disc degeneration,etc.) are assumed to be related to the occurrence of clinical symptoms of LSS.

© 2015 Lippincott Williams & Wilkins, Inc.