Lumbar spinal stenosis associated with peripheral arterial disease: a prospective multicenter observational studyReport as inadecuate




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Journal of Orthopaedic Science

, Volume 17, Issue 6, pp 673–681

First Online: 28 September 2012Received: 05 June 2012Accepted: 12 August 2012

Abstract

BackgroundIntermittent 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.

Methods570 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.

ResultsThe 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.

ConclusionsAdvanced 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.

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Author: Kazuhide Uesugi - Miho Sekiguchi - Shin-ichi Kikuchi - Masahiro Kanayama - Kazuhisa Takahashi - Kazuhiro Chiba - Minoru Doi

Source: https://link.springer.com/







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