Extended reports
Prevalence of stenotic changes in arteries supplying the lumbar
spine. A postmortem angiographic study on 140 subjects
Department of
Forensic Medicine, University of Helsinki, Kytösuontie 11, SF-00014
Helsinki, Finland
Correspondence to: Dr L I Kauppila, 16 Cranmore Road, Wellesley, MA 02181, USA.
Accepted for publication 17 July 1997
OBJECTIVES
To study the prevalence of arterial
diseases in the arteries supplying the lumbar spine and their relation
to other vascular diseases, as well as to chronic low back pain.
METHODSFive pairs of the lumbar arteries and
the middle sacral artery were evaluated from 140 postmortem aortograms,
performed in connection with routine medicolegal necropsies on subjects
ranging from 16 to 89 years of age. For information about low back pain history, a close relative of each of the deceased was interviewed two
to four weeks after the necropsy.
RESULTSTwenty one (22%) men and nine (20%)
women had occluded arteries, and an additional 33 (35%) men and 17 (38%) women had narrowed arteries. The mean age for men with occluded
or narrowed arteries, or both, was 50 years and for women 59 years.
Most of the stenotic changes were seen at the orifices or in the first
part of the arteries. The middle sacral artery was most often affected,
followed by the fourth lumbar arteries. The number of collateral
arteries increased with occluded (p <0.001) and narrowed arteries (p = 0.001). Stenotic lumbar/middle sacral arteries were found, on average,
five years earlier than atherosclerosis of the coronary arteries.
Subjects with one or more occluded/narrowed arteries were 8.5 times
more likely to have suffered from chronic (that is, three months or
longer) low back pain at some time during their life than were those
without such findings (odds ratio adjusted for age and sex 8.5; 95%
confidence intervals 2.9, 24; p <0.001).
CONCLUSIONSThe study shows that the lumbar and
middle sacral arteries frequently become obliterated by atheromatous
lesions during adult life, and that obliteration of these arteries is
more common in subjects with a history of chronic back pain than in
those without.
© 1997 by Annals of the Rheumatic Diseases
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