The Relationship Between The Lumbar Lordosis And Severity Of Spinal Canal Stenosis In Patients With Degenerative Lumbar Spinal Stenosis

Objective This study aims to study the relationship between the severity of spinal canal stenosis and lumbar lordosis in patients with lumbar spinal stenosis,and explore the progression of lumbar spinal stenosis,in order to provide some theoretical evidence for evaluation of the severity,progression,prognosis and treatment of this disease.Methods From January 2014 to December 2016,114 participants were retrospectively reviewed in this study,which included 59 patients with degenerative lumbar spinal stenosis treated at the First Affiliated Hospital of Zhengzhou University(study group,A)and 55 healthy person(control group,B)basing on the inclusion and exclusion criteria of degenerative lumbar spinal stenosis.And these two groups were further divided into male and female sub group respectively.The sagittal lumbar curvature was measured on the sagittal magnetic resonance imaging(MRI)with the method of the vertebral centroid measurement of lumbar lordosis(CLL)in both groups,and the dural cross-sectional area of canal(DAC),bony cross-sectional area of canal(BAC)were also measured on the axial view of MRI as well as the ratio of dural crosssectional area / bony cross-sectional area of canal.The independent-samples T test was used for the comparison of the CLL between group A and B.the Pearson′s correlation test was used for correlation analysis of the CLL with the DAC,BAC,DAC/BAC in group A.The statistically significant difference was set as P<0.05.Results 1.(1)In group A,the average angle of CLL in the sub group of male and female were 9.26±3.18;10.56±3.21 respectively,and were12.59±1.84;22.32±3.19 respectively in the sub group of male and female of group B.(2)There was a significant difference between the group A and group B both in the sub group of male and female(t : 3.042,5.784,p=0.004,0.000 respectively).2.In group A,the average DAC in the sub group of male and female were 85.34±20.02,78.96±11.71 respectively,and the average BAC were 220.42±18.76,220.90±10.30 respectively.The average ratio of DAC / BAC in the sub group of male and female were 0.387±0.084,0.357±0.048 respectively.(2)In group A,there was a significant correlation between CLL and DAC both in the sub group of male and female of group(r :0.788,0.841,p : 0.000,0.000 respectively).There was a significant correlation between CLL and DAC / BAC both in the sub group of male and female of group(r: 0.754,0.850 respectively,p:0.000,0.000 respectively).There was no significant correlation between CLL and BAC both in the sub group of male and female of group(r: 0.319,0.245,p : 0.075,0.218 respectively).Conclusion 1.The patients with degenerative lumbar spinal stenosis seem to have less lumbar lordosis than the healthy people.2.There is a significant correlation between the severity of lumbar spinal stenosis and the degree of loss of lumbar lordosis.