Morphometric Study of Lumbar Spinal Canal Dimensions in Bosnia and Herzegovina Population

Background: The lumbar spinal canal consists of 5 interconnected lumbar vertebrae through which the final part of the spinal cord passes and the lumbar and sacral spinal nerves that form the cauda equina. The lumbar canal stenosis can directly affect neurological symptoms and pain in the lumbar region and lower extremities. Due to the frequency of such symptoms, lumbar stenosis has been the subject of research around the world. Objective: The objective of this study was to measure, analyze and compare the mediosagital and interpeduncular diameters of the lumbar spinal canal in the population of Bosnia and Herzegovina to other populations around the world. Methods: We conducted a retrospective descriptive study on patients (n=200) who underwent Multi-slice computer tomography (MSCT) performed on a 40-slice CT scanner (Siemens Somatom Definition AS) for lumbar pain between January 1, 2013 and December 31, 2014. Age, gender, midsagittal (MSG) and interpeduncular (IP) diameters of the lumbar spine were recorded for each patient. Results: Results of our study show that the largest MSG diameter is at L1 level for both sexes, with an average length of 19,06mm, and the smallest at L3 level, with an average length of 16,66mm. Our study shows that the MSG diameter is significantly larger in females than males on all levels from L1 to L5. In both sexes, MSG diameter shows the form of an hourglass with narrowing at L3 level. IPD is largest at L5 level for both sexes, with an average length of 31,94mm, and the smallest average length at L1 level, at 24,78mm. IPD diameter is significantly larger in males than females on all levels from L1 to L5. IPD shows a tendency of growth from L1 to L5 in both sexes. Conclusion: There were significant differences in the dimensions of the lumbar spine canal between female and male patients. We found significant difference in MSG and IP diameters measurements between Bosnian and Herzegovinian population compared to other populations. The dimensions of the lumbar canal provide a baseline of normative data for the evaluation of patients presenting with lower back pain and lumbar canal stenosis in study population.