Original Article

Journal of Orthopaedic Science

, Volume 17, Issue 6, pp 673-681

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

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

  • Kazuhide UesugiAffiliated withDepartment of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • , Miho SekiguchiAffiliated withDepartment of Orthopaedic Surgery, Fukushima Medical University School of Medicine Email author 
  • , Shin-ichi KikuchiAffiliated withDepartment of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • , Masahiro KanayamaAffiliated withSpine Center, Hakodate Central General Hospital
  • , Kazuhisa TakahashiAffiliated withDepartment of Orthopedic Surgery, Graduate School of Medicine, Chiba University
  • , Kazuhiro ChibaAffiliated withDepartment of Orthopedic Surgery, Keio University
  • , Minoru DoitaAffiliated withDepartment of Orthopedic Surgery, Kobe University
  • , Yasumitsu ToribatakeAffiliated withDepartment of Orthopedic Surgery, Koseiren Takaoka Hospital
  • , Hiroshi MatsuoAffiliated withMatsuo Vascular Ultrasound Laboratory, Matsuo Clinic
    • , Kazuo YonenobuAffiliated withDepartment of Orthopedic Surgery, Osaka Minami Medical Center
    • , Yukihiro MatsuyamaAffiliated withDepartment of Orthopedic Surgery, Hamamatsu University School of Medicine
    • , Shin-ichi KonnoAffiliated withDepartment of Orthopaedic Surgery, Fukushima Medical University School of Medicine

Abstract

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.