Clinical and radiological characteristics of concomitant peripheral arterial obstructive disease in patients with lumbar spinal stenosis.
BACKGROUND
Intermittent claudication is a typical symptom of lumbar spinal stenosis (LSS) and peripheral arterial obstructive disease (PAD). Because both LSS and PAD are predominantly associated with degenerative conditions, concomitant conditions are not uncommon. However, few reports of the demographic, clinical, and radiological characteristics of concomitant LSS and PAD (LSSPAD) have been published.


OBJECTIVE
To identify the demographic, clinical, and radiological risk factors for concomitant PAD in LSS.


METHODS
A retrospective matched-control study.


METHODS
This study involved a retrospective cohort of 43 consecutive patients with LSSPAD and a control cohort of 45 age- and gender-matched patients diagnosed with LSS without PAD. Each patient in both groups underwent plain lumbar radiographs, magnetic resonance imaging of the lumbar spine, and ankle-brachial index (ABI) measurement. Demographic and clinical parameters were obtained. The abdominal aorta calcification score (AACS) was evaluated on the lateral lumbar radiographs. Computed tomographic angiography (CTA) of the lower limb was performed to confirm PAD.


RESULTS
The mean age of the LSSPAD group was 67.7 ± 10.7 years (52 - 88 years). The prevalence of diabetes mellitus (DM) was significantly higher in the LSSPAD group than in the LSS group (P = 0.022). The mean ABI was 0.71 ± 0.22 (0.32 - 0.91) for the LSSPAD group and 0.96 ± 0.18 (0.83 - 1.10) for LSS group (P < 0.001). The prevalence of aortic calcification was significantly higher in the LSSPAD group than in the LSS group (P < 0.001). The mean AACS was 10.2 ± 3.2 (2 - 18) for the LSSPAD group and 3.4 ± 4.1 (0 - 14) for the LSS group (P < 0.001).


CONCLUSIONS
Retrospective design.


CONCLUSIONS
We found that concomitant PAD in patients with LSS is associated with old age, DM, the presence of aortic calcification, and ABI < 0.9. When these risk factors exist, further work up is needed to exclude the concomitant PAD.
Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Seung-Hwan
SH
Han
Chang-Hoon
CH
Jeon
Doo-Hyung
DH
Lee
Ho-Sik
HS
Choo
Nam-Su
NS
Chung
D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*