Lumbar Spinal Stenosis in Patients with Acromegaly: An MRI-Based Case-Control Study.

OBJECTIVE

To evaluate the prevalence of lumbar spinal stenosis (LSS) in patients with acromegaly, and to explore the etiology and risk factors for developing LSS.

METHODS

A case-control study was conducted. The study enrolled 52 patients with acromegaly, and 104 patients with pain in lower back and/or lower extremities from orthopedic outpatient clinic were matched based on age and sex. The primary outcome for this study was the prevalence of LSS, and the secondary outcome was dural sac cross-sectional area, which is a quantitative index to assess the extent of stenosis. Among patients with acromegaly, additional analyses were performed to identify risk factors associated with LSS.

RESULTS

The prevalence of LSS in patients with acromegaly was higher than that in the control group (35 of 52, 67% vs. 31 of 104, 29%; χ2 = 19.973, P < 0.001). Compared to orthopedic outpatients, the odds ratio for LSS among acromegaly patients was 4.848 (95% CI: 2.370-9.918, P < 0.001). Patients in acromegaly group tended to have younger age of LSS onset (45 ± 10 years vs. 51 ± 9 years, P = 0.015), and longer segment involvement (2.7 ± 1.0 vs. 1.7 ± 0.7, P < 0.001). Higher nadir growth hormone levels were independently associated with the presence of LSS (adjusted odds ratio: 1.387, 95% CI 1.056-1.820, P = 0.019).

CONCLUSIONS

Patients with acromegaly had higher prevalence of LSS, which prompts timely screening for lumbar abnormalities among this population.