Age-related radiographic parameters difference between the degenerative lumbar spinal stenosis patients and healthy people and correlation analysis

Abstract

Objectives: To identify age-related radiographic risk factors for DLSS and analyze correlations among them. Methods: 180 cases were enrolled in this study, and lumbar magnetic resonance was performed. Among them, 93 cases suffered DLSS and lumbar dynamic X-ray were examined. And following parameters were measured: intervertebral disc height(IDH), the ratio of IDH(IDHL4-5/L3-4), initial IDH of L4-5(iIDHL4-5) in the DLSS group, disc degeneration (DD), cartilaginous endplate failure(CEF), Modic changes, the thickness of ligamentum flavum(LF), range of intervertebral motion(ROM), facet joint opening(FJO), facet joint angle(FJA)， the standard cross-sectional area(SCSA) of the multifidus, erector spinae and psoas major muscles. The data of two groups were compared, and the possible risk factors of DLSS were analyzed. Results: Compared with the control group, the DLSS group had higher IDH except for L4-5, and larger iIDHL4-5(P<0.05). Significant differences were shown in CEF and the thickness of LF at L1-S1, and DD at L4-5(P<0.05). The DLSS group had smaller SCSA of multifidus, erector spinae, and psoas major muscles but greater FJA、FJO(P<0.05). And the risk of DLSS increased when iIDHL4-5≥10.73mm, FJA≥52.03° or FJO≥3.75mm. IDH positively correlated with SCSA of multifidus and psoas major muscles and ROM at L1-S1 (P<0.05). DD showed negative linear relations with SCSA of multifidus and psoas muscle and positive linear relation with CEF at L1-2, L2-3, and L5-S1(P<0.05). Conclusion: Larger initial disc height and excessive CEF may induce DLSS by increasing intervertebral mobility to promote DD, and atrophied paravertebral muscles by weakening the stability of lumbar spine.