Spinal stenosis prevalence and association with symptoms: The Framingham Study

By Leonid Kalichman, R. Cole, David H. Kim, Ling Li, P. Suri, A. Guermazi, D. Hunter. The spine journal, 2009

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Background Context The prevalence of lumbar spinal stenosis (LSS) in the general population and association with low back pain (LBP) remains unclear. Purpose 1) to evaluate the prevalence of congenital and acquired LSS observed on computed tomography (CT) in a community-based sample; 2) to evaluate the association between LSS and LBP. Study design/Setting Cross-sectional observational study. This study was an ancillary project to the Framingham Heart Study. Sample 3529 participants underwent multi-detector CT. 191 were enrolled in this study. Outcome Measures Self-report Measures LBP in the preceding 12 months was evaluated using a self-report questionnaire. Physiologic Measures LSS (congenital and acquired) was characterized using two cut-points: 12 mm for relative LSS, and 10 mm for absolute LSS. Methods Using multiple logistic regression we examined the association between LSS and LBP, adjusting for sex, age and BMI. Results In the congenital group, relative LSS was found in 4.7% and absolute LSS in 2.6% of patients. Acquired LSS was found in 22.5% and in 7.3%, respectively. Acquired LSS showed increasing prevalence with age: <40 years, the prevalence of relative and absolute LSS was 20.0% and 4.0%, respectively; in those 60–69 years the prevalence was 47.2% and 19.4%, respectively. The presence of absolute LSS was associated with LBP with an odds ratio of 3.16 (95% CI: 1.05–9.53). Conclusions The prevalence of congenital and acquired LSS in a community-based sample was characterized. The prevalence of acquired stenosis increased with age. LSS is associated with a three-fold higher risk of experiencing LBP.

Subfields: Anesthesiology and Pain Medicine, Pathology and Forensic Medicine, Surgery

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