Association of developmental lumbar spinal canal stenosis and stunting

Abstract

Objective: To determine a possible relationship between developmental lumbar spinal canal stenosis (DLSS) and stunting. Background: Stunting is due to failure of longitudinal length with shortened long bones. Stunted individuals have failure of growth of long bones implying a possibility of involvement of short and flat bones. The hypothesis in this study is that DLSS is part of a generalized skeletal dysplasia. Materials and Methods: This is a cross-sectional study (CSA) of 400 patients looking at the association of DLSS with stunting. The study compares the size of the spinal canal in individuals with stunting and those without stunting. Stunting was defined according to the WHO/UNICEF criteria of −2SD of the median height of the same population. The participants were divided into two types: those who were deemed stunted and those who were not. DLSS was similarly defined as −2SD of the relevant measured parameter. The study included skeletally mature patients between 18 and 60 years. All syndromic individuals, those with spine tumors and previous spine surgery, were excluded. Results: Four hundred individuals were sampled from a pool of 597 participants. One hundred and eight or 27% were stunted. The stunted individuals had statistically significantly shallow canal depths or anteroposterior diameters (11.2 ± 2.0 mm vs. 14.6 ± 2.6 mm, t(398) = −11.1, P < 0.001), and narrower canal widths (transverse diameters) (14.6 ± 3.3 mm vs. 18.8 ± 4.5 mm, t(398) = −8.1, P < 0.001) and smaller CSAs (134.0 ± 49.4 mm vs. 220.2 ± 82.0, t(398) = −9.4, P < 0.001) when compared to individuals with normal heights. Odds ratio was 10. Conclusions: Stunted individuals have smaller lumbar spinal canals when compared to nonstunted individuals. It can be concluded that developmental lumbar spinal canal stenosis is part of a generalized skeletal dysplasia.