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. 2022 Sep 12;23(1):857.
doi: 10.1186/s12891-022-05810-y.

MRI grading of spinal stenosis is not associated with the severity of low back pain in patients with lumbar spinal stenosis

Masakazu Minetama  1 , Mamoru Kawakami  2   3 , Masatoshi Teraguchi  2 , Sachika Matsuo  2 , Yoshio Enyo  2 , Masafumi Nakagawa  2 , Yoshio Yamamoto  2 , Tomohiro Nakatani  2 , Nana Sakon  2 , Wakana Nagata  2 , Yukihiro Nakagawa  2
Affiliations

MRI grading of spinal stenosis is not associated with the severity of low back pain in patients with lumbar spinal stenosis

Masakazu Minetama et al. BMC Musculoskelet Disord. .

Abstract

Background: Although lumbar spinal stenosis (LSS) often coexists with other degenerative conditions, few studies have fully assessed possible contributing factors for low back pain (LBP) in patients with LSS. The purpose of this study was to identify factors associated with the severity of LBP in patients with LSS.

Methods: The patients with neurogenic claudication caused by LSS, which was confirmed by magnetic resonance imaging (MRI) were included in this cross-sectional study. Data included ratings of LBP, buttock and leg pain, and numbness on a numerical rating scale (NRS), 36-item Short-Form Survey (SF-36) scores, muscle mass measured by bioelectrical impedance analysis, and radiographic measurements including lumbopelvic alignment and slippage. The severity of LSS, endplate defects, Modic endplate changes, intervertebral disc degeneration, and facet joint osteoarthritis were evaluated on MRI. Spearman correlation and multivariate linear regression analyses were used to examine the factors associated with the severity of LBP (NRS score).

Results: A total of 293 patients (135 male and 158 female, average age 72.6 years) were analyzed. LBP was moderately correlated with buttock and leg pain, and buttock and leg numbness. Significant but weak correlations were observed between LBP and body mass index, appendicular and trunk muscle mass, all domains of SF-36, pelvic tilt, total number of endplate defects and Modic endplate changes, and summary score of disc degeneration grading, but not severity or number of spinal stenoses. In the multivariate regression analysis, age, female sex, trunk muscle mass, diabetes, NRS buttock and leg pain, NRS buttock and leg numbness, SF-36 vitality, pelvic tilt, and total number of endplate defects were associated with the severity of LBP.

Conclusions: Trunk muscle mass, lumbopelvic alignment, and endplate defects, but not severity of stenosis are partly associated with severity of LBP, but buttock and leg pain and buttock and leg numbness have strongest relationships with LBP in patients with LSS.

Keywords: Disc degeneration; Endplate defects; Facet joint osteoarthritis; Low back pain; Lumbar spinal stenosis; Magnetic resonance imaging; Modic changes; Muscle mass; Spinal alignment; Spondylolisthesis.

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Conflict of interest statement

The authors declare that they have no competing interests” in this section.

Figures

Fig. 1
Fig. 1
The factors correlated with LBP
See this image and copyright information in PMC

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