Factors associated with lumbar spinal stenosis in a large-scale, population-based cohort: The Wakayama Spine Study

被引：21

作者：

Maeda, Takahiro ^{[1
]}

Hashizume, Hiroshi ^{[1
]}

Yoshimura, Noriko ^{[2
]}

Oka, Hiroyuki ^{[3
]}

Ishimoto, Yuyu ^{[1
]}

Nagata, Keiji ^{[1
]}

Takami, Masanari ^{[1
]}

Tsutsui, Shunji ^{[1
]}

Iwasaki, Hiroshi ^{[1
]}

Minamide, Akihito ^{[1
]}

Nakagawa, Yukihiro ^{[1
]}

Yukawa, Yasutsugu ^{[1
]}

Muraki, Shigeyuki ^{[2
]}

Tanaka, Sakae ^{[4
]}

Yamada, Hiroshi ^{[1
]}

Yoshida, Munehito ^{[1
,5
]}

机构：

[1] Wakayama Med Univ, Dept Orthopaed Surg, Wakayama, Wakayama, Japan

[2] Univ Tokyo, Fac Med, 22nd Century Med & Res Ctr, Dept Prevent Med Locomot Organ Disorders,Bunkyo K, Tokyo, Japan

[3] Univ Tokyo, Fac Med, 22nd Century Med & Res Ctr, Dept Med Res & Management Musculoskeletal Pain,Bu, Tokyo, Japan

[4] Univ Tokyo, Fac Med, Dept Orthopaed Surg, Bunkyo Ku, Tokyo, Japan

[5] Sumiya Orthopaed Hosp, Dept Orthopaed Surg, Wakayama, Wakayama, Japan

来源：

PLOS ONE | 2018年 / 13卷 / 07期

基金：

日本学术振兴会;

关键词：

OLDER-ADULTS; PREVALENCE; COMPLICATIONS; SURGERY; TRENDS; PAIN;

D O I：

10.1371/journal.pone.0200208

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Objective Patients with lumbar spinal stenosis (LSS) who have radiographically similar degrees of stenosis may not necessarily exhibit equivalent symptoms. As part of a cross-sectional study, we examined factors associated with symptomatic LSS (sLSS) in the general population of Japan. Methods We evaluated 968 participants (men, 319; women, 649) between 2008 and 2010. Orthopedic surgery specialists diagnosed sLSS using interview results, medical examinations, and imaging findings. LSS was radiographically graded using a 4-level scale. Additionally, we examined basic anthropometry, smoking habits, alcohol consumption, ankle-brachial index values (ABI), and glycosylated hemoglobin (HbA1c) levels. We grouped patients with moderate and severe radiographic LSS, and compared the indicated factors on the basis of the presence/absence of sLSS. Data were evaluated using multiple logistic regression analyses. Results Radiographically, 451 participants had moderate and 288 severe stenosis. Clinically, 92 participants were diagnosed with sLSS, including 36 with moderate and 52 with severe stenosis. In the moderate stenosis group, participants with sLSS had significantly higher rates of diabetes mellitus (DM) and lower ABIs than did non-LSS participants. Although sLSS participants tended to be older (p = 0.19), there were no significant differences in the sex distribution, body mass index values, or in the percentages of participants who were drinkers/smokers. In the severe stenosis group, there were no differences in any of the evaluated factors. Multiple logistic regression showed that DM (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.52-9.34]) and low ABI (1 SD = 0.09; OR, 1.36; 95% CI, 1.04-1.81) were significantly associated with LSS in the moderate stenosis group. Conclusions DM and low ABIs are significantly associated with sLSS in patients with moderate radiographic stenosis. Neither factor is associated with sLSS in patients with severe stenosis. Notably, the effects of intrinsic factors on symptomology may be masked when anatomic stenosis is severe.

引用

页数：12