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Chiropractic Research Review

Small Lumbar Canal May Increase Risk for LBP

Studies have shown that the amount of space in the lumbar canal may dictate the prevalence of discal symptoms and other causes of lumbar pain. The size of the spinal canal can be affected by local injury or systemic problems caused by malnutrition or illness during development.

Allometric growth (varying growth rates of different dimensions in the body) can be measured in the lumbar spine and may be linked to low back pain (LBP).

This study was designed to evaluate the allometric relationships between different measurements of the lumbar canal, and to determine if these measures differ between asymptomatic individuals and those with LBP or sciatica. Thirty-nine healthy controls and 119 back-pain patients received anteroposterior radiographs, lateral radiographs, and computed tomography (CT) scans of the lumbar spine. The CT scans focused on continuous slices from L3 to S1 in patients assuming a supine position, and a radiologist made measurements of the sagittal diameter of the canal; interarticular distance; inter-pedicular distance; and anteroposterior diameter of the foramen and lateral recess. The results of the scans are listed below:

* Asymptomatic individuals had wider foramina from L3 to L5 and larger sagittal diameters in S1 than those with back pain.

* Symptomatic subjects with canal stenosis showed smaller diameters in the central canal, the lateral recess of L4, and foramina in L4 and L5.

The authors suggest that people with normal canal diameters may be able to better tolerate degenerative changes that result in fewer clinical signs and symptoms than people with narrower diameters. Disturbance of growth in the early phases of life could be the origin of congenital narrow canals, which in this study were associated with symptoms of LBP and sciatica in adult life.

Santiago FR, Milena GL, Herrera RO, et al. Morphometry of the lower lumbar vertebrae in patients with and without low back pain. European Spine Journal 2001:10(3), pp. 228-233.

Chiropractic Research Review

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