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Arch Orthop Trauma Surg. 2013 Nov;133(11):1477-82. doi: 10.1007/s00402-013-1832-4.

Impact of spinal imbalance and BMI on lumbar spinal canal stenosis determined by a diagnostic support tool: cohort study in community‑living people.

Abstract

INTRODUCTION:

The Japanese Society for Spine Surgery and Related Research (JSSR) developed a diagnostic support tool (score range −2 to 16) for lumbar spinal canal stenosis (LSS). It is well known that patients with LSS have a forward-bending posture while walking. We could find only one study which examined sagittal alignment of LSS patients. The objectives of this study were to screen community-living people with LSS, and to investigate the association between LSS and spinal sagittal alignment, range of motion (ROM), and other spinal or physical factors.

MATERIALS AND METHODS:

We enrolled 286 subjects ≥50 years old in the study. We regarded those with a JSSR diagnostic risk score ≥7 as having LSS. We measured and evaluated lateral lumbar radiographs, sagittal parameters, sagittal balance, and spinal mobility as determined with SpinalMouse®, back muscle strength (BMS), and body mass index (BMI). Spinal inclination angle (SIA) was used as an index of sagittal balance.

RESULTS:

Multivariate logistic regression analysis indicated that increased BMI (OR 1.121, p < 0.05) and SIA (OR 1.144, p < 0.05) were important relevant factors for LSS. BMI had significant positive correlations with SIA (r = 0.214), and thoracic and lumbar kyphosis angles (r = 0.283, 0.131), and negative correlations with sacral slope angle (r = −0.166), and lumbar and total spinal ROMs (r = −0.270, −0.166). SIA had significant positive correlations with age (r = 0.334), BMI (r = 0.214) and lumbar kyphosis angle (r = 0.525), and negative correlations with BMS (r = −0.268), and lumbar and total spinal ROMs (r = −0.184, −0.171).

CONCLUSIONS:

Increased SIA and BMI might be the most relevant risk factors for LSS.

PMID:
23959069
DOI:
10.1007/s00402-013-1832-4
[Indexed for MEDLINE]

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