Lumbar vertebral canal stenosis: concept of morphometric and radiometric study of the human lumbar vertebral canal

Abstract

Objectives: Vertebral canal stenosis has attracted the attention of anatomists and clinician as an important structural change with significant radiological and clinical implications. Narrowing of all diameters of the vertebral foramen with age could be responsible as a factor which might produce back pain. The aim of the present study was to estimate the averages anatomical changes in the transverse and anteroposterior diameters of the lumbar vertebral canal in Egyptian population to establish a clue to the underlying some causes of the low-back pain of unknown etiology. Methods:The present study investigated the lumbar part of the vertebral column of 20 adult skeletons and 200 plain Xrays of normal living subjects (100 males and 100 females) for both morphometric and radiometric analyses. Results:The mean width of the body of vertebrae showed gradual increase with the exception at L4 in dry bones. In addition, the mean width and depth of the vertebral foramina showed a gradual increase with the exception of L3 in dry bones. The study recorded a positive relationship between the mean width of the vertebral foramen and that of the body. The mean vertebral foramen width/body ratio was 0.6 except at L3 and L5 where the ratio was 0.5. Conclusion:The present study has shown a narrower depth of the lumbar vertebral canal in Egyptian population. L3 remains the center point for transition in the dimensions and hence more susceptible to stenosis and spinal nerve compression. This study has also shown that the ratio between the width of body and foramen of lumbar vertebrae remains constant. By this ratio it may be possible to predict any lumbar vertebral anomalies or vertebral canal stenoses and to give some explanation about low-back pain of unknown etiology.

Normative dimensions of lumbar canal and dural sac by computer tomography in Togo

“…Statistically, there was no significant difference of the APD between male and female in our study. The same remark was made by El-Rakhawy et al [8] in Pakistan. The comparison of the dimensions of our study with those of Amonoo-Kuofi et al [5] in Nigeria, of Ongolo Zogo et al [9] in Cameroon, of Tarek et al [6] in Egypt, and of El Rakhawy et al [8] in Pakistan and with that of Getroa [10] in Belgium did not find significant difference statistically.…”

“…The same remark was made by El-Rakhawy et al [8] in Pakistan. The comparison of the dimensions of our study with those of Amonoo-Kuofi et al [5] in Nigeria, of Ongolo Zogo et al [9] in Cameroon, of Tarek et al [6] in Egypt, and of El Rakhawy et al [8] in Pakistan and with that of Getroa [10] in Belgium did not find significant difference statistically. But our study found significant difference statistically in APD1 measurements with the study of Lee et al [7] in Korea.…”

“…The study of El-Rakhawy et al [8] in Pakistan found higher values in L4 and L5 and the lowest value in L3. Thus, many studies [5][6][7][8] agree on the fact that the smallest measurement of the APD is in L3. Statistically, there was no significant difference of the APD between male and female in our study.…”

“…Tarek et al [6] and Ongolo Zogo et al [9] found respectively in Egyptians and in Cameroonians similar results. On the other hand, El-Rakhawy et al [8] noticed an average IPD almost identical at the level of the four first lumbar vertebrae (≈ 24mm) followed by an increase in L5 (28.48mm). The comparison of the IPD between our study and those of Ongolo Zogo et al [9] in Cameroon, of Amonoo-Kuofi et al [12] in Nigeria, of Tarek et al [6] in Egypt, of El-Rakhawy M et al [8] in Pakistan did not show any significant difference statistically.…”

“…On the other hand, El-Rakhawy et al [8] noticed an average IPD almost identical at the level of the four first lumbar vertebrae (≈ 24mm) followed by an increase in L5 (28.48mm). The comparison of the IPD between our study and those of Ongolo Zogo et al [9] in Cameroon, of Amonoo-Kuofi et al [12] in Nigeria, of Tarek et al [6] in Egypt, of El-Rakhawy M et al [8] in Pakistan did not show any significant difference statistically. But on the other hand, the studies of Postachini et al [13] and of Piera et al [14] showed that the IPD would be different across populations.…”