INTRODUCTION: We have reported that the prevalence of lumbar spinal stenosis (LSS) with peripheral arterial disease (PAD) (LSSPAD) was 6.7%, and the clinical characteristics of LSSPAD were elderly patients, male, and the high prevalence of diabetes, ischemic heart disease and arrhythmia. The aim of this study was to compare the improvements of symptoms and QOL after treatments between LSS patients with and without PAD.
METHODS: A total of 570 patients diagnosed with LSS by the clinical diagnostic support tool and MRI at 64 medical facilities were enrolled in this study. History taking, physical examination, ankle‐brachial index (ABI), the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and the Short Form 36 (SF‐36) were performed. LSS patients with PAD or ABI below 0.9 were in the LSSPAD group, while LSS patients without PAD were in the control group. Statistical analyses were performed using t test, Mann‐Whitney's U test, and multivariate recurrence analysis. P values less than 0.05 were considered statistically significant.
RESULTS: Of the 570 enrolled, 488 (78.6%; 234 males, 214 females) were followed up on at three months after treatment. The LSSPAD group included 30 patients (6.7%). There was no significant difference of treatments for LSS between the LSSPAD (nonsurgery 53.3%, surgery 46.7%) and the control (non‐surgery 48.1%, surgery 51.9%) groups. The improvement of pain in the buttocks and legs in the LSSPAD group was less than in the control group (p<0.05). Scores on the JOABPEQ did not differ significantly between the LSSPAD and control groups. While improvements of scores on “general health” of the SF‐36 were lower in the LSSPAD group compared with the control group (p<0.05).
DISCUSSION: Patients with LSSPAD might have intractable pain in the buttocks and legs, and have less improvement of QOL. Clinicians should consider the prevalence of PAD in LSS patients with intermittent caludication.