Brief Report: Lumbar Spinal Stenosis Is a Highly Genetic Condition Partly Mediated by Disc Degeneration. Issue 12 (December 2014)

• Record Type: Journal Article
• Authors: Battié, Michele C.; Ortega‐Alonso, Alfredo; Niemelainen, Riikka; Gill, Kevin; Levalahti, Esko; Videman, Tapio; Kaprio, Jaakko
• Is Part Of: Arthritis & rheumatology. Volume 66:Issue 12(2014)
• Page Start: 3505
• Page End: 3510
• Publication Date: 2014-12
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/art.38823
• Languages: English
• ISSNs: 2326-5191

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="art38823-sec-0001" sec-type="section"> <title>Objective</title> <p>Lumbar spinal stenosis is one of the most commonly diagnosed spinal disorders in older adults. Although the pathophysiology of the clinical syndrome is not well understood, a narrow central canal or intervertebral foramen is an essential or defining feature. The aim of the present study was to estimate the magnitude of genetic versus environmental influences on central lumbar spinal stenosis and to investigate disc degeneration and stature or bone development as possible genetic pathways.</p> </sec> <sec id="art38823-sec-0002" sec-type="section"> <title>Methods</title> <p>A classic twin study with multivariate analyses considering lumbar level and other covariates was conducted. The study sample comprised 598 male twins (147 monozygotic and 152 dizygotic pairs), 35–70 years of age, from the population‐based Finnish Twin Cohort. The primary phenotypes were central lumbar stenosis as assessed qualitatively on magnetic resonance imaging (MRI) and quantitatively measured dural sac cross‐sectional area. Additional phenotypes (to examine possible genetic pathways) included disc bulging and standing height, as an indicator of overall skeletal size or development.</p> </sec> <sec id="art38823-sec-0003" sec-type="section"> <title>Results</title> <p>The heritability estimate (h<sup>2</sup>) for qualitatively assessed central lumbar spinal stenosis on MRI was 66.9% (95% confidence interval [95% CI] 56.8, 74.5). The broad‐sense heritability estimate for dural sac cross‐sectional area was 81.2% (95% CI 74.5, 86.1), with a similar magnitude of genetic influences across lumbar levels (h<sup>2</sup> = 72.4–75.6). The additive genetic correlation of quantitatively assessed stenosis and disc bulging was extremely high. There was no indication of shared genetic influences between stenosis and stature.</p> </sec> <sec id="art38823-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Central lumbar spinal stenosis and associated dural sac dimensions are highly genetic, and disc degeneration (bulging) appears to be one pathway through which genes influence spinal stenosis.</p> </sec> </abstract>