Factors Associated With Low Back Pain In Patients With Lumbar Spinal Stenosis: A Cross-Sectional Study

Background: Low back pain (LBP) is a major symptom of lumbar spinal stenosis (LSS). To develop better treatment, it is important to assess LBP in patients with LSS. This study aimed to analyze the factors associated with LBP in patients with LSS. Methods: : This cross-sectional study included consecutive patients with LSS aged between 51 and 79 years who had symptoms in one or both legs with or without LBP. The participants were classified into two groups: the high group (LBP visual analog scale [VAS] score of 30 mm or more) and the low group (LBP VAS score of less than 30 mm). We performed multiple logistic regression analysis with the high and low groups as dependent variables and a receiver operating characteristic (ROC) analysis. Results: : A total of 80 patients with LSS were included (35 men and 45 women; mean age 64.5 years), with 47 and 30 patients in the high and low groups, respectively. Multivariate logistic regression analysis revealed that the sagittal vertical axis (SVA; + 1; odds ratio [OR], 1.029; 95% confidence interval [CI], 1.005−1.052) and pelvic incidence (PI)-lumbar lordosis (LL; + 1; OR, 1.065; 95% CI 1.019–1.168) were significantly associated with LBP. ROC analysis revealed cut-off values of 47.0 mm and 30.5° of PI-LL, respectively. Conclusion: These cut-off values could have a high specificity and positive predictive value for LBP in patients with LSS due to spinopelvic malalignment. However, these cut-off values could also represent with a cause other than LSS due to spinopelvic malalignment.