Spinal stenosis prevalence and association with symptoms: the Framingham Study

Spine J. 2009 Jul;9(7):545-50. doi: 10.1016/j.spinee.2009.03.005. Epub 2009 Apr 23.


Background context: The prevalence of lumbar spinal stenosis (LSS) in the general population and association with low back pain (LBP) remain unclear.

Purpose: To evaluate the prevalence of congenital and acquired LSS observed on computed tomography in a community-based sample; and to evaluate the association between LSS and LBP.

Study design/setting: Cross-sectional observational study. This study was an ancillary project to the Framingham Heart Study.

Patient sample: A total of 3,529 participants underwent multidetector computed tomography; 191 were enrolled in this study.

Outcome measures: Self-report measures: LBP in the preceding 12 months was evaluated using a self-report questionnaire. Physiologic measures: LSS (congenital and acquired) was characterized using two cut-points: 12mm for relative LSS and 10mm for absolute LSS.

Methods: Using multiple logistic regression, we examined the association between LSS and LBP, adjusting for sex, age, and body mass index.

Results: In the congenital group, relative LSS was found in 4.7% and absolute LSS in 2.6% of patients. Acquired LSS was found in 22.5% and in 7.3%, respectively. Acquired LSS showed increasing prevalence with age less than 40 years, the prevalence of relative and absolute LSS was 20.0% and 4.0%, respectively, and in those 60 to 69 years the prevalence was 47.2% and 19.4%, respectively. The presence of absolute LSS was associated with LBP with an odds ratio of 3.16 (95% confidence interval [CI]: 1.05-9.53).

Conclusions: The prevalence of congenital and acquired LSS in a community-based sample was characterized. The prevalence of acquired stenosis increased with age. LSS is associated with a threefold higher risk of experiencing LBP.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Low Back Pain / diagnostic imaging
  • Low Back Pain / epidemiology*
  • Low Back Pain / etiology*
  • Male
  • Middle Aged
  • Prevalence
  • Spinal Stenosis / complications*
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / epidemiology*
  • Tomography, X-Ray Computed