Influence of radiological factors, psychosocial factors, and central sensitization-related symptoms on clinical symptoms in patients with lumbar spinal canal stenosis

Abstract

BACKGROUND: No study to date has concurrently evaluated the impact of radiological factors, psychosocial factors, and central sensitization (CS) related symptoms in a single lumbar spinal canal stenosis (LSS) patient cohort. OBJECTIVE: To investigate the associations between these factors and clinical symptoms in LSS patients. METHODS: We recruited 154 patients with LSS scheduled for surgery. Patient-reported outcome measures and imaging evaluation including clinical symptoms, psychosocial factors, CS-related symptoms, and radiological classifications. Spearman’s rank correlation coefficient and multiple regression analyses were employed. RESULTS: Spearman’s correlation revealed CS-related symptoms positively correlated with low back pain (r= 0.25, p< 0.01), leg pain (r= 0.26, p< 0.01), and disability (r= 0.32, p< 0.01). Pain catastrophizing positively correlated with leg pain (r= 0.23, p< 0.01) and disability (r= 0.36, p< 0.01). Regression analysis showed that pain catastrophizing was associated with disability (β= 0.24, 95%CI = 0.03–0.18), and CS-related symptoms with low back pain (β= 0.28, 95%CI = 0.01–0.09). Radiological classifications were not associated with clinical symptoms. CONCLUSION: Our findings suggest that psychosocial factors and CS-related symptoms, rather than radiological factors, seem to contribute to clinical symptoms in patients with LSS.