title: Risk factors and incidence for peripheral arterial disease in patients with typical lumbar spinal stenosis.
abstract: OBJECTIVE
  Intermittent claudication (IC) is a typical symptom of peripheral arterial disease (PAD) and lumbar spinal stenosis (LSS). In order to prevent misdiagnosis of vascular disease, it is important to know the incidence of and risk factors for PAD in patients with LSS. Therefore, the aim of our study was to evaluate the incidence of and risk factors for PAD in patients with typical and severe LSS who underwent spinal surgical treatment.
  
  
  METHODS
  The occurrence of PAD was examined retrospectively in 171 consecutive patients with LSS and severe IC who underwent surgical treatment at our hospital from June 2012 to June 2013. Data were collected on background characteristics (sex, age) and known risk factors for PAD, such as hypertension, diabetes mellitus, smoking, hyperlipidemia, stroke, and ischemic heart disease.
  
  
  RESULTS
  Of the 171 patients enrolled, 7 had an abnormal ankle-brachial index (ABI). Computed tomography angiography (CTA) was performed in these patients, and a final diagnosis of PAD was established for all 7 patients. The incidence of PAD in all patients with LSS was 4.1%(7 of 171). Stroke and ischemic heart disease were significantly more common in the LSSPAD group compared with the LSS group. Multiple logistic regression analyses with a forced-entry method revealed that age and stroke (p<0.05) were independent risk factors for PAD.
  
  
  CONCLUSIONS
  To prevent misdiagnosis of fatal PAD, we recommend ABI be assessed in patients with LSS and history of stroke.
authors.affiliation: Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Min-Hee
authors.initials: MH
authors.lastname: Han
authors.affiliation: Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Dong-Hyun
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Ki-Su
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Chung-Ang University School of Medicine, Seoul, Korea.
authors.forename: Young-Seok
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Kyoung-Tae
authors.initials: KT
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Joo-Kyung
authors.initials: JK
authors.lastname: Sung
authors.affiliation: Division of Transplantation and Vascular Surgery, Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Hyung-Kee
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Dae-Chul
authors.initials: DC
authors.lastname: Cho
keywords: Ankle brachial pressure index; Lumbar spinal stenosis; Peripheral arterial disease