The Spine Journal
Volume 9, Issue 7 , Pages 545-550 , July 2009

Spinal stenosis prevalence and association with symptoms: the Framingham Study

  • Leonid Kalichman, PhD, PT

      Affiliations

    • Clinical Epidemiology Research and Training Unit, Boston University, 650 Albany Street (X Building), Suite 200, Boston, MA 02118, USA
  • ,
  • Robert Cole, BA

      Affiliations

    • Clinical Epidemiology Research and Training Unit, Boston University, 650 Albany Street (X Building), Suite 200, Boston, MA 02118, USA
  • ,
  • David H. Kim, MD

      Affiliations

    • Division of Research, Boston University School of Medicine, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA
    • Department of Orthopaedic Surgery, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA
  • ,
  • Ling Li, MPH

      Affiliations

    • Division of Research, Boston University School of Medicine, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA
  • ,
  • Pradeep Suri, MD

      Affiliations

    • Division of Research, Boston University School of Medicine, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA
  • ,
  • Ali Guermazi, MD

      Affiliations

    • Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, Boston, MA 02118, USA
  • ,
  • David J. Hunter, MBBS, PhD

      Affiliations

    • Division of Research, Boston University School of Medicine, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA
    • Corresponding Author InformationCorresponding author. Division of Research, Boston University School of Medicine, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA. Tel.: (617) 754-6655; fax: (617) 754-5728.

Received 8 August 2008 ,Accepted 12 March 2009.

References 

  1. De Villiers PD, Booysen EL. Fibrous spinal stenosis. A report on 850 myelograms with a water-soluble contrast medium. Clin Orthop Relat Res. 1976;115:140–144
  2. Roberson GH, Llewellyn HJ, Taveras JM. The narrow lumbar spinal canal syndrome. Radiology. 1973;107:89–97
  3. Fanuele JC, Birkmeyer NJ, Abdu WA, Tosteson TD, Weinstein JN. The impact of spinal problems on the health status of patients: have we underestimated the effect?. Spine. 2000;25:1509–1514
  4. Gunzburg R, Keller TS, Szpalski M, Vandeputte K, Spratt KF. A prospective study on CT scan outcomes after conservative decompression surgery for lumbar spinal stenosis. J Spinal Disord Tech. 2003;16:261–267
  5. Arnoldi CC, Brodsky AE, Cauchoix J, et al. Lumbar spinal stenosis and nerve root entrapment syndromes. Definition and classification. Clin Orthop Relat Res. 1976;115:4–5
  6. Splansky GL, Corey D, Yang Q, et al. The third generation cohort of the national heart, lung, and blood Institute's Framingham Heart Study: design, recruitment, and initial examination. Am J Epidemiol. 2007;165:1328–1335
  7. Hoffmann U, Siebert U, Bull-Stewart A, et al. Evidence for lower variability of coronary artery calcium mineral mass measurements by multi-detector computed tomography in a community-based cohort—consequences for progression studies. Eur J Radiol. 2006;57:396–402
  8. Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18:233–237
  9. Ullrich CG, Binet EF, Sanecki MG, Kieffer SA. Quantitative assessment of the lumbar spinal canal by computed tomography. Radiology. 1980;134:137–143
  10. Verbiest H. Pathomorphologic aspects of developmental lumbar stenosis. Orthop Clin North Am. 1975;6:177–196
  11. Bolender NF, Schonstrom NS, Spengler DM. Role of computed tomography and myelography in the diagnosis of central spinal stenosis. J Bone Joint Surg Am. 1985;67:240–246
  12. Sortland O, Magnaes B, Hauge T. Functional myelography with metrizamide in the diagnosis of lumbar spinal stenosis. Acta Radiol Suppl. 1977;355:42–54
  13. Verbiest H. The significance and principles of computerized axial tomography in idiopathic developmental stenosis of the bony lumbar vertebral canal. Spine. 1979;4:369–378
  14. Eisenstein S. Measurements of the lumbar spinal canal in 2 racial groups. Clin Orthop Relat Res. 1976;115:42–46
  15. Drew R, Bhandari M, Kulkarni AV, Louw D, Reddy K, Dunlop B. Reliability in grading the severity of lumbar spinal stenosis. J Spinal Disord. 2000;13:253–258
  16. Haig AJ, Geisser ME, Tong HC, et al. Electromyographic and magnetic resonance imaging to predict lumbar stenosis, low-back pain, and no back symptoms. J Bone Joint Surg Am. 2007;89:358–366
  17. Coste J, Judet O, Barre O, Siaud JR, Cohen de Lara A, Paolaggi JB. Inter- and intraobserver variability in the interpretation of computed tomography of the lumbar spine. J Clin Epidemiol. 1994;47:375–381
  18. Ciol MA, Deyo RA, Howell E, Kreif S. An assessment of surgery for spinal stenosis: time trends, geographic variations, complications, and reoperations. J Am Geriatr Soc. 1996;44:285–290
  19. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72:403–408
  20. Wiesel SW, Tsourmas N, Feffer HL, Citrin CM, Patronas N. A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. Spine. 1984;9:549–551
  21. Jansson KA, Blomqvist P, Granath F, Nemeth G. Spinal stenosis surgery in Sweden 1987-1999. Eur Spine J. 2003;12:535–541
  22. LaBan MM, Imas A. “Young” lumbar spinal stenotic: review of 268 patients younger than 51 years. Am J Phys Med Rehabil. 2003;82:69–71
  23. Lee BC, Kazam E, Newman AD. Computed tomography of the spine and spinal cord. Radiology. 1978;128:95–102
  24. Schonstrom NS, Bolender NF, Spengler DM. The pathomorphology of spinal stenosis as seen on CT scans of the lumbar spine. Spine. 1985;10:806–811
  25. Jarvik JJ, Hollingworth W, Heagerty P, Haynor DR, Deyo RA. The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: baseline data. Spine. 2001;26:1158–1166
  26. Kent DL, Haynor DR, Larson EB, Deyo RA. Diagnosis of lumbar spinal stenosis in adults: a metaanalysis of the accuracy of CT, MR, and myelography. AJR Am J Roentgenol. 1992;158:1135–1144
  27. Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002;137:586–597
  28. de Graaf I, Prak A, Bierma-Zeinstra S, Thomas S, Peul W, Koes B. Diagnosis of lumbar spinal stenosis: a systematic review of the accuracy of diagnostic tests. Spine. 2006;31:1168–1176
  29. Eisenstein S. Lumbar vertebral canal morphometry for computerised tomography in spinal stenosis. Spine. 1983;8:187–191

 FDA device/drug status: not applicable.

 Author disclosures: LK (supported by an Arthritis Foundation Postdoctoral Grant); DJH (supported by a research grant from DonJoy, Wyeth, MERCK, Pfizer, Stryke, and Lilly); DHK (consulting fees from Medtronic, DePuy, Stryker, Zimmer, Syntle; research support for staff and materials from New England Baptist Hospital); and AG (stock ownership in Synarc Inc; office in a company, president, BICL, LLC).

 This work was supported by the National Heart, Lung, and Blood Institute's Framingham Heart Study contract (No. N01-HC-25195) for the recruitment, enrollment, and examination of the Offspring and Third Generation cohort and the imaging by computed tomography scan.

PII: S1529-9430(09)00117-X

doi: 10.1016/j.spinee.2009.03.005

The Spine Journal
Volume 9, Issue 7 , Pages 545-550 , July 2009