Abstract
The aim of the current study was to establish whether the vertebral morphometry (e.g., vertebral body width and spinal canal diameters) is associated with degenerative lumbar spinal stenosis (DLSS). A retrospective computerized tomography (CT) study from L1 to L5 for two sample populations was used. The first included 165 participants with symptomatic DLSS (sex ratio 80 M/85F), and the second had 180 individuals from the general population (sex ratio: 90 M/90F). Vertebral body length (VL) and width (VW) were significantly greater in the stenosis males and females compared to their counterparts in the control. The mean VL in the stenosis males was 31.3 mm at L1, 32.6 mm at L2, 34 mm at L3, 34.1 mm at L4, and 34.5 at L5 compared to 29.9 mm, 31.3 mm, 32.6 mm, 32.8 mm, and 32.9, respectively, in the control group (P ≤ 0.003). Additionally, the bony anterior-posterior (AP) canal diameters and cross-sectional area (CSA) were significantly smaller in the stenosis group compared to the control. The mean AP canal values in the stenosis males were 17.8 mm at L1, 16.6 mm at L2, 15.4 mm at L3, 15.6 mm at L4, and 16.1 at L5 compared to 18.7, 17.8, 16.9, 17.6, and 18.8, respectively, in the control group. Vertebral length (OR-1.273 to 1.473; P ≤ 0.002), AP canal diameter (OR-0.474 to 0.664; P ≤ 0.007), and laminar inclination (OR-0.901 to 0.856; P ≤ 0.025) were significantly associated with DLSS. Our study revealed that vertebral morphometry has a role in DLSS development.
Highlights
Lumbar spinal stenosis is defined as an encroachment of the neurovascular elements and can be developmental and acquired [1]
It has been previously reported that subjects with Degenerative lumbar spinal stenosis (DLSS) have greater vertebral body size than the controls and the pedicle width increases the risk for DLSS development
The vertebral body length and width values from L1 to L5 levels were significantly greater in both males and females of the stenosis group compared with their counterparts in the control (Table 1)
Summary
Lumbar spinal stenosis is defined as an encroachment of the neurovascular elements and can be developmental (congenital) and acquired [1]. Congenital stenosis is multileveled segments that appears in the younger age (30 to 40 years), whereas the acquired degenerative is by far the most common type usually single level that is related to the advanced age of 50th to 60th years [2, 3]. Degenerative lumbar spinal stenosis (DLSS) is typically associated with degeneration of the intervertebral disc anteriorly, as well as 2-facet joints and ligamentum flavum posteriorly [3,4,5]. There is some evidence that correlates this phenomenon with the vertebral bony morphology besides to the degenerative process in the spine segment [10, 11]. We hypothesize that vertebral morphometry may have a role in the pathogenesis of DLSS
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