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- Publisher Website: 10.1302/0301-620X.103B1.BJJ-2020-1186.R2
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Article: Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability
Title | Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability |
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Authors | |
Issue Date | 2021 |
Publisher | British Editorial Society of Bone and Joint Surgery. The Journal's web site is located at http://www.bjj.boneandjoint.org.uk/ |
Citation | The Bone & Joint Journal, 2021, v. 103-B n. 1, p. 131-140 How to Cite? |
Abstract | Aims: To study the associations of lumbar developmental spinal stenosis (DSS) with low back pain (LBP), radicular leg pain, and disability.
Methods: This was a cross-sectional study of 2,206 subjects along with L1-S1 axial and sagittal MRI. Clinical and radiological information regarding their demographics, workload, smoking habits, anteroposterior (AP) vertebral canal diameter, spondylolisthesis, and MRI changes were evaluated. Mann-Whitney U tests and chi-squared tests were conducted to search for differences between subjects with and without DSS. Associations of LBP and radicular pain reported within one month (30 days) and one year (365 days) of the MRI, with clinical and radiological information, were also investigated by utilizing univariate and multivariate logistic regressions.
Results: Subjects with DSS had higher prevalence of radicular leg pain, more pain-related disability, and lower quality of life (all p < 0.05). Subjects with DSS had 1.5 (95% confidence interval (CI) 1.0 to 2.1; p = 0.027) and 1.8 (95% CI 1.3 to 2.6; p = 0.001) times higher odds of having radicular leg pain in the past month and the past year, respectively. However, DSS was not associated with LBP. Although, subjects with a spondylolisthesis had 1.7 (95% CI 1.1 to 2.5; p = 0.011) and 2.0 (95% CI 1.2 to 3.2; p = 0.008) times greater odds to experience LBP in the past month and the past year, respectively.
Conclusion: This large-scale study identified DSS as a risk factor of acute and chronic radicular leg pain. DSS was seen in 6.9% of the study cohort and these patients had narrower spinal canals. Subjects with DSS had earlier onset of symptoms, more severe radicular leg pain, which lasted for longer and were more likely to have worse disability and poorer quality of life. In these patients there is an increased likelihood of nerve root compression due to a pre-existing narrowed canal, which is important when planning surgery as patients are likely to require multi-level decompression surgery. |
Persistent Identifier | http://hdl.handle.net/10722/295334 |
ISSN | 2023 Impact Factor: 4.9 2023 SCImago Journal Rankings: 2.280 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lai, MKL | - |
dc.contributor.author | Cheung, WHP | - |
dc.contributor.author | Samartzis, D | - |
dc.contributor.author | Karppinen, J | - |
dc.contributor.author | Cheung, KMC | - |
dc.contributor.author | Cheung, JPY | - |
dc.date.accessioned | 2021-01-11T13:58:38Z | - |
dc.date.available | 2021-01-11T13:58:38Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | The Bone & Joint Journal, 2021, v. 103-B n. 1, p. 131-140 | - |
dc.identifier.issn | 2049-4394 | - |
dc.identifier.uri | http://hdl.handle.net/10722/295334 | - |
dc.description.abstract | Aims: To study the associations of lumbar developmental spinal stenosis (DSS) with low back pain (LBP), radicular leg pain, and disability. Methods: This was a cross-sectional study of 2,206 subjects along with L1-S1 axial and sagittal MRI. Clinical and radiological information regarding their demographics, workload, smoking habits, anteroposterior (AP) vertebral canal diameter, spondylolisthesis, and MRI changes were evaluated. Mann-Whitney U tests and chi-squared tests were conducted to search for differences between subjects with and without DSS. Associations of LBP and radicular pain reported within one month (30 days) and one year (365 days) of the MRI, with clinical and radiological information, were also investigated by utilizing univariate and multivariate logistic regressions. Results: Subjects with DSS had higher prevalence of radicular leg pain, more pain-related disability, and lower quality of life (all p < 0.05). Subjects with DSS had 1.5 (95% confidence interval (CI) 1.0 to 2.1; p = 0.027) and 1.8 (95% CI 1.3 to 2.6; p = 0.001) times higher odds of having radicular leg pain in the past month and the past year, respectively. However, DSS was not associated with LBP. Although, subjects with a spondylolisthesis had 1.7 (95% CI 1.1 to 2.5; p = 0.011) and 2.0 (95% CI 1.2 to 3.2; p = 0.008) times greater odds to experience LBP in the past month and the past year, respectively. Conclusion: This large-scale study identified DSS as a risk factor of acute and chronic radicular leg pain. DSS was seen in 6.9% of the study cohort and these patients had narrower spinal canals. Subjects with DSS had earlier onset of symptoms, more severe radicular leg pain, which lasted for longer and were more likely to have worse disability and poorer quality of life. In these patients there is an increased likelihood of nerve root compression due to a pre-existing narrowed canal, which is important when planning surgery as patients are likely to require multi-level decompression surgery. | - |
dc.language | eng | - |
dc.publisher | British Editorial Society of Bone and Joint Surgery. The Journal's web site is located at http://www.bjj.boneandjoint.org.uk/ | - |
dc.relation.ispartof | The Bone & Joint Journal | - |
dc.title | Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability | - |
dc.type | Article | - |
dc.identifier.email | Cheung, WHP: gnuehcp6@hku.hk | - |
dc.identifier.email | Cheung, KMC: cheungmc@hku.hk | - |
dc.identifier.email | Cheung, JPY: cheungjp@hku.hk | - |
dc.identifier.authority | Cheung, KMC=rp00387 | - |
dc.identifier.authority | Cheung, JPY=rp01685 | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1302/0301-620X.103B1.BJJ-2020-1186.R2 | - |
dc.identifier.scopus | eid_2-s2.0-85099214303 | - |
dc.identifier.hkuros | 320898 | - |
dc.identifier.volume | 103-B | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | 131 | - |
dc.identifier.epage | 140 | - |
dc.identifier.isi | WOS:000604990700019 | - |
dc.publisher.place | United Kingdom | - |