Prevalence of developmental lumbar spinal canal stenoses among adult population in the coastal region of Kenya

Abstract

Background: There is considerable variability in the size of the adult lumbar spinal canal between and within populations.

Objective: This study purposed to determine the prevalence of Developmental Lumbar Spinal Canal Stenosis (DLSS) in an impoverished population. Assuming DLSS is part of generalized stunting and therefore, influenced by nutrition, a higher prevalence rate of DLSS was expected in the region. This would explain the severity of symptoms encountered in association with chronic low back pain and radiculopathy.

Design: Observational cross-sectional survey.

Methods: The study was carried out between October 2017 and January 2018. One thousand one hundred and ninety-eight people were recruited and 436 participants were sampled for the study. Basic anthropometric measurements were done. History of hunger and food shortage was taken. Observations were made for
presence or absence of enamel hypoplasia and spina bifida. Using axial sections of MRI and CT scans, canal dimensions were measured in each of the 5 lumbar vertebras (L1-L5).

Results: Males constituted 50.3% of the sample population, rest were female. The mean age was 45 years. The mean canal depth was 13.8 ±2.5 mm, width 17.8±3.6 mm, and the mean cross-sectional area was 200 ±70 mm². Developmental lumbar spinal canal stenosis was diagnosed when the CSA was less than -2SD. The prevalence rate of DLSS was 19%.

Conclusion: The prevalence of DLSS in the African population living in the Coastal regions of Kenya was found to be 19% and highly related to stunting.

Keywords: Prevalence, Poverty, malnutrition, Developmental, Stenosis