Lumbar Spinal Stenosis Clinical Trial
Official title:
Risk Factors for Ligamentum Flavum Hypertrophy in Lumbar Spinal Stenosis Patients From Xinjiang Uygur Autonomous Region of China: a Retrospective, Single-center, Case Analysis
To measure ligamentum flavum thickness in patients with different nationalities, sexes, heights, ages, and weights from Xinjiang Uygur Autonomous Region of China with CT, explore the correlation between various factors and ligamentum flavum thickness, provide reference for pedicle screw placement and lumbar decompression surgery, develop individualized surgical programs, and can effectively reduce the incidence of unnecessary postoperative complications induced by misplacement.
History and current related studies With the increase of human social activities, spinal
degenerative disease is increasing year by year. Due to the special anatomical structures
and biomechanical characteristics, lumbar vertebrae easily suffer from lumbar spinal
stenosis. Lumbar spinal stenosis is a medical condition in which the spinal canal narrows
and compresses the spinal cord and nerves at the level of the lumbar vertebra. Vertebral
spondylolisthesis, facet joint hyperplasia, bony spur posterior extension, intervertebral
disc prolapse/protrusion, and ligamentum flavum hypertrophy are common causes for
degenerative lumbar spinal stenosis, and ligamentum flavum hypertrophy is one of the
important causes for spinal stenosis. When conservative treatment is ineffective, the
occurrence of muscle paralysis or bladder symptoms caused by nerve compression requires
surgical treatment. Commonly used surgical methods include pedicle screw fixation,
flavectomy, laminectomy and facetectomy. Therefore, important anatomical structures will be
involved in the operation, such as pedicle, ligamentum flavum, lamina, and articular
process.
Many previous studies concern pedicle morphology, lumbar ligamentum flavum, lamina and
articular process, and important reference data are listed in Table 1. Safak et al. verified
that ligamenta flavum thickness was not associated with sex; ligamenta flavum was remarkably
thicker on the left side of segments L4/5 and L5/S1 than that on the right side; ligamenta
flavum thickness was not positively correlated with age. Few studies address whether
ligamenta flavum thickness was associated with nationality, sex and obesity.
Data collection, management, analysis and open-access
1. Written and electronic data were collected. The electronic data were stored in a
specialized computer, and locked by the data manager. The written data were stored and
locked in a reference room. The key was kept by the data manager and laboratory
manager.
2. The locked database was not altered and was preserved, along with the original records.
The database was statistically analyzed by a professional statistician.
3. Prior to any analysis of the data, the analysis plan outlined in this section would be
reviewed, and detailed statistical analysis plans would be prepared and approved. All
data regarding this trial were preserved by the Sixth Affiliated Hospital, Xinjiang
Medical University, China.
4. Anonymized trial data would be published at www.figshare.com.
Statistical analysis
1. All data were analyzed using SPSS 21.0 software (IBM, Armonk, NY, USA).
2. All measurement data were normally distributed and expressed as mean ± standard
deviation.
3. Ligamentum flavum thickness was compared among groups using two-sample t-test or
one-way analysis of variance. Paired comparison between groups was conducted using
Student-Newman-Keuls test. Correlation of nationality, sex, height, age and weight with
ligamentum flavum thickness was analyzed using Pearson's correlation coefficient. Risk
factors for ligamentum flavum hypertrophy were analyzed using multiple linear
regression analysis. Odd ratio and 95% confidence interval were calculated.
4. The significance level was α = 0.05.
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