Correlation between lumbar vertebral compression fractures and lumbar spinal stenosis and the influence of surgical methods on prognosis

Abstract

Abstract Study Design: Retrospective Cohort StudyOBJECTIVE We conducted a retrospective study to evaluate the correlation of lumbar compression fractures (LCF) and lumbar spinal stenosis (LSS) ,and to explore the clinical outcomes of different surgical methods.METHODS A total of 134 eligible patients were divided into minor/moderate stenosis and severe/extreme stenosis groups .We counted the patients' age, sex, BMI, BMD, history of hypertension, diabetes, rheumatism and hormone used, symptom duration and history of trauma. The LLA, PI, lumbar spondylolisthesis, LSI(lumbar stenosis indexes) and fracture grades were calculated. The preoperative VAS, ODI and JOA scores of the patients were surveyed, and the clinical outcomes were followed up by telephone.RESULTS There is a clear correlation between the degree of LSS and the degree of fracture(r = 0.532,P < 0.0001). Severe/extreme stenosis groups was higher in BMI, proportion of trauma and lower extremity symptoms(P = 0.038, P = 0.023, P = 0.005) and lower PI(P < 0.001).There was no statistical difference in the improvement of VAS, ODI and JOA between different surgical methods (P = 0.093, P = 0.545, P = 0.576).Furthermore, for patients with preoperative lower extremity symptoms, the prognosis of decompression surgery is better than that of non-decompression surgery(improvement of VAS ,ODI ,JOA :P = 0.042, 0.032, 0.597,respective).CONCLUSIONS There is a clear correlation between LCF and LSS. For patients with severe LCF, it is necessary to perform relevant imaging examinations and pay attention to whether LSS is combined, especially for patients with trauma, obesity or low PI. If the patient has lower extremity symptoms, decompression surgery can be considered if the patient's general condition permits.