Comparison of spine-pelvic parameters between lumbar spinal stenosis with and without diffuse idiopathic skeletal hyperostosis

English Keywords:Lumbar spinal stenosis  Diffuse idiopathic skeletal hyperostosis  Spine-pelvic parameters

English Abstract:

  【Abstracts】 Objectives: To evaluate the effects of diffuse idiopathic skeletal hyperostosis(DISH) on the spine-pelvic parameters of lumbar spinal stenosis(LSS) patients. Methods: A total of 40 LSS patients with DISH from January 2014 to June 2017 was retrospectively reviewed. There were 23 males and 17 females, aged 51 to 75 years with a mean age of 65.1±7.3. Another 40 LSS patients without DISH were selected as control group. There were 23 males and 17 females, aged 51 to 75 years with a mean age 64.7±7.1. There was no statistically significant difference in gender, age or responsible levels(P>0.05). The spinal-pelvic parameters including thoracic kyphosis(TK), lumbar lordosis(LL), sagittal vertical axis(SVA), pelvic incidence(PI), pelvic tilt (PT), sacral slope(SS), lumbar-sacral angle(LSA), L5 incidence(L5I) were measured accordingly. The scores of VAS and ODI were assessed for each patient. The independent t test was used to analyze the difference between two groups. Results: The SVA of LSS patients with DISH was significantly lower than that of LSS patients without DISH(20.0±38.7mm vs. 40.0±46.3mm, P=0.039). There were no significant differences between two groups in TK(27.2°±10.7° vs 25.5°±16.0°), LL(48.1°±13.7° vs 47.1°±13.5°), PI(51.4°±14.1° vs 52.5°±13.9°), PT(18.0°±8.0° vs 19.0°±7.6°), SS(33.6°±9.5° vs 34.4°±7.8°), LSA(17.0°±12.0° vs 18.4°±6.7°) and L5I(22.4°±9.8° vs 24.7°±11.9°)(P>0.05). LSS patients with DISH were associated with both higher VAS scores of back pain and lower limbs pain, and higher ODI score than control group(5.6±1.0 vs 5.4±1.2, 6.5±1.3 vs 6.2±1.7, 36.9±4.9 vs 36.8±5.0). However, the difference was not statistically significant(P>0.05). Conclusions: SVA is significantly reduced in LSS patients with DISH compared to those without DISH. There are no significant difference between two groups in TK, LL, PI, PT, SS, LSA and L5I. In addition, DISH seems to show no significant effect on the quality of life of LSS patients.