Relationship Among the Foraminal Area and Demographic and Clinical Characteristics of Patients with Low Back Pain

Abstract

OBJECTIVE: Our study aims to contribute to existing knowledge by evaluating patients with low back pain to provide a more accurate relationship between the diameter of the intervertebral foramen and the clinical, demographic, and lumbar spine anatomic factors such as age, sex, body mass index, the Zurich Claudication Questionnaire, facet joint, intervertebral disc, ligamentum flavum, and spinal canal. METHODS: We studied 90 consecutive patients who had undergone evaluation for low back pain. We used magnetic resonance imaging to assess the cross-sectional areas of the intervertebral foramina at each level of the lumbar spine together with the ligamentum flavum area and the dural sac cross-sectional area (DSCSA) measurements. The presence of disc and facet joint degeneration was evaluated and data on symptoms were obtained. RESULTS: Age (P < 0.0001), lumbar disc degeneration grade (P = 0.016), and DSCSA (P < 0.0001) were found to statistically significantly influence the foraminal area (FA). The mean FA at all lumbar levels increased with increasing DSCSA. The mean FA decreased with age at all levels except L5/S1. Lumbar disc degeneration grade 1-3 increased the mean FA at L5/S1, but not at other levels. No statistically significant effects of the side of the measurement, sex, body mass index, Zurich Claudication Questionnaire score, ligamentum flavum area, or facet joint degeneration were found. CONCLUSIONS: The results of the present study allow us to quantify the effect of age, DSCSA, and lumbar disc degeneration grade on the FA.