Association between early life malnutrition and the size of lumbar spinal canal among adults of coastal region, Kenya

Abstract

Background: The aetiology of chronic low back pain is largely unknown. A high prevalence of developmentally narrow canals may explain some of the aetiology or the accompanying nervous tissue compression that often accompany.
Objective: To determine the relationship between early life malnutrition and the development of lumbar spinal canal. A relationship between early life malnutrition and developmental narrowing would indirectly incriminate such predictors as poverty, aridity and human development which can be reduced by policy and strategy.
Methods: This was an observational cross sectional survey. The participants were screened for Early Life Malnutrition (ELM) using a semi-structured questionnaire. Various observations and measurements were made which included measurement of the dimensions of the spinal canal on MRI or CT scans of the lumbosacral spine. The cross sectional area was used for determination. The frequencies and means were compared in the group with ELM and the one without.
Results: The results showed the prevalence of ELM in the adult population of coastal Kenya to be 29% and the prevalence of Developmental Lumbar Spinal Canal Stenosis (DLSS) was16%. Those with ELM had a higher prevalence of DLSS (20%) than those without (14%), p = 0.003. There were differences in DLSS dimensional means between those with ELM and those without, depth (P = 0.046), cross sectional area (P = 0.042), and in width (P = 0.176). There was a strong negative linear relationship between the canal depth (APD), r =-0.68, cross sectional area (CSA), r = -0.65, and a moderate negative linear relationship with the canal width (TRD), r = -0.50.
Conclusions: The present study shows a high prevalence rate of ELM and DLSS in the study population. There is a higher prevalence of DLSS in those with ELM. The two shows a strong negative linear relationship between ELM and DLSS. ELM may partly be responsible for developmentally narrow canals.

Key words: Early-life-malnutrition, Developmental narrowing, Lumbar spinal canal stenosis, Prevalence, Low back pain, Sciatica