Lumbar spinal stenosis associated with peripheral arterial disease: a prospective multicenter observational study.
BACKGROUND
Intermittent 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.


METHODS
570 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.


RESULTS
The 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).


CONCLUSIONS
Advanced 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.
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1-Hikarigaoka, Fukushima, Fukushima 960-1295, Japan.
Kazuhide
K
Uesugi
Miho
M
Sekiguchi
Shin-ichi
S
Kikuchi
Masahiro
M
Kanayama
Kazuhisa
K
Takahashi
Kazuhiro
K
Chiba
Minoru
M
Doita
Yasumitsu
Y
Toribatake
Hiroshi
H
Matsuo
Kazuo
K
Yonenobu
Yukihiro
Y
Matsuyama
Shin-Ichi
S
Konno
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D013130:Spinal Stenosis / Q000150:complications*