Analysis of Factors Related to Low Back Pain in Lumbar Spinal Stenosis

• Published in: Journal of Spine Research Vol. 13; no. 5; pp. 770 - 777
• Main Authors: Ogon, Izaya, Yoshimoto, Mitsunori, Takebayashi, Tsuneo, Terashima, Yoshinori, Yamashita, Toshihiko, Takashima, Hiroyuki
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Spine Surgery and Related Research 20.05.2022; 一般社団法人 日本脊椎脊髄病学会
• Subjects: low back pain; lumbar spinal stenosis; spinopelvic alignment; 脊柱・骨盤アライメント; 腰痛; 腰部脊柱管狭窄症
• ISSN: 1884-7137; 2435-1563
• DOI: 10.34371/jspineres.2021-0038

Introduction: The purpose of this study was to analyze the factors associated with low back pain (LBP) in patients with lumbar spinal stenosis (LSS).Methods: In total, 120 patients with LSS (52 males and 68 females; mean age, 64.1±1.8 years) participated in this study. LBP was defined as pain on the posterior aspect of the trunk between the 12th rib and the lower end of the glenoid groove that lasts for > 3 months. The patients were classified into two groups: high (H) group, which had a LBP visual analog scale (VAS) score > 30 mm, and the low (L) group, which had a LBP VAS score ≤30 mm. The age, gender, body mass index, neurological disorder pattern, bone mineral density, slippage, spinopelvic alignment, disc degeneration, cross sectional area and fatty infiltration of the multifidus muscle, Modic changes, and facet degeneration were compared between the H and L groups. Multiple logistic regression analysis was performed with group H and L as dependent variables.Results: In the H and L groups, the mean lower leg pain VAS was 73.3±4.6 mm and 50.3±3.5 mm (p< 0.01), the mean lower leg numbness VAS was 76.2±4.9 mm and 51.2±4.1 mm (p< 0.01), the mean lumbar lordosis (LL) was 32.6±3.0° and 40.4±3.1° (p< 0.01), the mean sagittal vertical axis (SVA) was 54.4±6.6 mm and 29.2±6.2 mm (p< 0.01), the mean sacral slope was 27.7°±1.3° and 32.3°±1.4° (p< 0.05), and the mean pelvic incidence (PI) -LL was 15.9°±0.8° and 9.6°±0.7° (p< 0.01), respectively. A multiple logistic regression analysis showed that SVA (OR, 1.017; 95% CI: 1.003-1.031, p < 0.05) and PI-LL (OR, 1.058; 95% CI: 1.012-1.152, p < 0.05) were significantly associated with LBP.Conclusions: SVA and PI-LL were considered to be associated with LBP in patients with LSS.