Aeolus myth: chronic obstructive lung disease and nocturnal lumbosacral pain in association with lumbar spinal stenosis and pulmonary hypertension.
OBJECTIVE
To describe an association between the syndromes of lumbar spinal stenosis and chronic obstructive pulmonary disease (COPD) in patients presenting with symptoms of nocturnal lumbosacral radiculopathy.


METHODS
Retrospective review of 46 sequential inpatients referred with complaints of lumbosacral radicular pain associated with lumbar spinal stenosis. Half (23) were experiencing sleep disruptive nocturnal pain. Each had been hospitalized with a primary diagnosis of COPD. They were subsequently compared with another group of inpatients (23) who were also experiencing lumbar pain not necessarily increased at night. Each was also identified as having lumbar spinal stenosis without an antecedent history of COPD. In each case, lumbar spinal imaging studies (computed tomography or magnetic resonance imaging) were obtained. Pulmonary function tests were performed in those with COPD, and two-dimensional echocardiograms were obtained in all 46 patients.


RESULTS
The ratio of women to men, their ages, surgical interventions, severity of lumbar spinal stenosis, and left ventricular function as compared one group with another was not significantly different. However, pulmonary artery pressures were notably elevated (i.e., pulmonary hypertension) in those with COPD and nocturnal lumbosacral radiculopathy.


CONCLUSIONS
This study suggests that in patients with COPD and lumbar spinal stenosis, pulmonary hypertension may be the dynamic link exacerbating nocturnal lumbosacral pain.
LaBan
Myron M
MM
Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Kucway
Eun-Jung
EJ
D000368:Aged; D002940:Circadian Rhythm; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D017116:Low Back Pain / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000150:complications*