Abstract
BackgroundIntermittent claudication is a common symptom of both lumbar spinal stenosis (LSS) and peripheral arterial disease (PAD) in middle-aged and elderly people. However, the prevalence and clinical characteristics of LSS with PAD (LSSPAD) have not been investigated in a multicenter study. The aim of this study was to investigate the prevalence and clinical characteristics of LSS associated with PAD. Methods570 patients diagnosed with LSS using a clinical diagnostic support tool and MRI at 64 facilities were enrolled. We evaluated each patient’s medical history, physical findings, ankle brachial index, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) score, and the Short Form 36 (SF-36) score. Statistical analyses were performed to compare LSSPAD patients and LSS patients without PAD using the t test, Mann–Whitney’s U test, and multivariate recurrence analysis. p values of <0.05 were considered statistically significant. ResultsThe LSSPAD group comprised 38 patients (6.7 %); 20 (3.5 %) had pre-diagnosised PAD while 18 (3.2 %) had undetected PAD. The clinical characteristics of these patients were advanced age, diabetes, and a history of ischemic heart disease and cerebrovascular disorder. 570 patients enrolled, and 448 (78.6 %) of those patients were followed up at three - months after enrollment. Pain in buttocks and legs improved less in the LSSPAD group than in the LSS group (p < 0.05). Improvements in the “general health” score in SF-36 were lower in the LSSPAD group than in the LSS group (p < 0.05). ConclusionsAdvanced age, diabetes, and a history of cerebrovascular disorder and ischemic heart disease were associated with LSSPAD. Because LSSPAD patients show less improvement in QOL than patients with LSS but without PAD do, clinicians should consider the coexistence of PAD in LSS patients.
Highlights
MethodsLumbar spinal stenosis (LSS) presents with lower extremity symptoms [1, 2], including neurogenic intermittent claudication as a typical symptom [3]
Improvements in the ‘‘general health’’ score in Short Form 36 (SF-36) were lower in the LSS with PAD (LSSPAD) group than in the lumbar spinal stenosis (LSS) group (p \ 0.05)
Advanced age, diabetes, and a history of cerebrovascular disorder and ischemic heart disease were associated with LSSPAD
Summary
MethodsLumbar spinal stenosis (LSS) presents with lower extremity symptoms [1, 2], including neurogenic intermittent claudication as a typical symptom [3]. Since there is overlap in the ages at which patients develop LSS and PAD, it is important to differentiate the claudication caused by these two different pathologies. Intermittent claudication is a common symptom of both lumbar spinal stenosis (LSS) and peripheral arterial disease (PAD) in middle-aged and elderly people. The prevalence and clinical characteristics of LSS with PAD (LSSPAD) have not been investigated in a multicenter study. No significant differences were seen between the LSSPAD group and the LSS group in the prevalence of hypertension, dyslipidemia, or hyperuricemia. The LSSPAD group had significantly higher rates of cerebrovascular disorder, ischemic heart disease, and arrhythmia when compared with the LSS group. No significant differences were seen between the LSSPAD group and LSS group in terms of history of alcohol intake or smoking. No significant difference was seen between the two groups in any other items in the hematological tests
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