Spinal sagittal balance and spinopelvic parameters in patients with degenerative lumbar spinal stenosis; a comparative study

•We evaluated sagittal balance and spinopelvic parameters in Iranian adult population.•We analyzed 48 patients with lumbar spine stenosis and 54 healthy subjects.•Lumbar canal stenosis is associated with increased frequency of sagittal imbalance.•Lumbar canal stenosis is associated with decreased lumbar lordosis and sacral slope.•Laminectomy without considering sagittal alignment causes a reduction in the outcome.

ObjectiveThis study aims to evaluate the spinal sagittal balance and the spinopelvic parameters in patients with degenerative lumbar spinal stenosis and healthy controls in Iranian population.MethodsWe performed a case-control study in which 48 patients with lumbar spine stenosis and 54 age- and sex-matched healthy subjects with back pain were eligible for participation. We used INFINITT picture archiving and communication systems (PACS) of the Chamran Hospital for selecting the patients for the study group. The sagittal balance, pelvic incidence, lumbar lordosis, and sacral slope were measured in all the patients and controls using thoracolumbosacral radiographies in the standing position.ResultsThere was no significant difference between the 2 groups regarding the baseline characteristics. The prevalence of sagittal imbalance was significantly higher in the patients with lumbar spine stenosis in comparison with the controls (31.2% vs. 14.8%; P < 0.001). The sacral slope was significantly lower in patients with lumbar canal stenosis than the healthy controls (31.39° ± 11.2 vs. 43.7° ± 8.4; P < 0.001). The lumbar lordosis was significantly lower in patients with lumbar canal stenosis than the controls (31.27° ± 12.4 vs. 45.8° ± 10.7; P < 0.001). The pelvic incidence was not significantly different between the 2 groups (50.16° ± 11.9 vs. 52° ± 9.6; P = 0.342).ConclusionThe degenerative lumbar canal stenosis is associated with increased sagittal imbalance and decreased lumbar lordosis and sacral slope in a sample of the Iranian adult population.