PREVALENCE OF STENOTIC CHANGES IN ARTERIES SUPPLYING THE LUMBAR SPINE- A POSTMORTEM ANGIOGRAPHIC STUDY ON 140 SUBJECTS

Objectives-To study the prevalence of arterial diseases in the arterie s supplying the lumbar spine and their relation to other vascular dise ases, as well as to chronic low back pain. Methods-Five pairs of the l umbar arteries and the middle sacral artery were evaluated from 140 po stmortem aortograms, performed in connection with routine medicolegal necropsies on subjects ranging from 16 to 89 years of age. For informa tion about low back pain history, a close relative of each of the dece ased was interviewed two to four weeks after the necropsy. Results-Twe nty one (22%) men and nine (20%) women had occluded arteries, and an a dditional 33 (35%) men and 17 (38%) women had narrowed arteries. The m ean age for men with occluded or narrowed arteries were 50 years and f or of the stenotic changes were seen at the orifices or in the first p art of the arteries. The middle sacral artery was most often affected, followed by the fourth lumbar arteries. The number of collateral arte ries increased with occluded (p < 0.001) and narrowed (p = 0.001). Ste notic lumbar/arteries were found, on average, five years earlier than atherosclerosis of the coronary arteries. Subjects with one or more oc cluded/narrowed arteries were 8.5 times more likely to have suffered f rom chronic (that is, three months or longer) low back pain at some ti me 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). Conclusions-The study shows that the lumbar and middle sacral a rteries frequently become obliterated by atheromatous lesions during a dult life, and that obliteration of these arteries is more common in s ubjects with a history of chronic back pain than in those without.