A diagnostic support tool for lumbar spinal stenosis: a self-administered, self-reported history questionnaire

Konno, Satoshi; Kikuchi, Shinichi; Tanaka, Yasuhisa; Yamazaki, Ken; Shimada, Yuko; Takei, Hiroshi; Yokoyama, T.; Okada, Masahiro; Kokubun, Shou-ichi

doi:10.1186/1471-2474-8-102

Cited by 78 publications

(100 citation statements)

References 16 publications

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“…In patients with strictly defined CNLBP (using a diagnostic support tool designed for lumbar spinal stenosis 13) ), the therapeutic efficacy of an NSAID and exercise seemed to be almost equivalent with regard to pain relief. However, the QOL of the patients was statistically improved in the exercise group but not in the NSAID group during the initial 3 months of this study.…”

Section: Discussionmentioning

confidence: 99%

“…The patients in the two groups were registered randomly (according to their medical examination) from among patients who had been newly diagnosed with possible NLBP at our hospital (using a diagnostic support tool designed for lumbar spinal stenosis 13) ). They also had to satisfy the inclusion criteria, did not meet any of the exclusion criteria, and agreed with the therapeutic approach of this study.…”

Section: Methodsmentioning

confidence: 99%

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Therapeutic efficacy of nonsteroidal anti-inflammatory drug therapy versus exercise therapy in patients with chronic nonspecific low back pain: a prospective study

Takahashi

Omata

Iwabuchi

et al. 2017

FJMS

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Therapy for chronic, nonspecific low back pain is mainly conservative : medication and/or exercise. Pharmacotherapy, however, has side effects, and the quantities of concomitant drugs in older persons require attention. Although exercise promises improved function, its use to alleviate pain is controversial. Thus, we compared the efficacy of pharmacotherapy versus exercise for treating chronic nonspecific low back pain. The pharmacotherapy group (n=18 : 8 men, 10 women) were prescribed celecoxib monotherapy. The exercise group (n=22 : 10 men, 12 women) undertook stretching exercises. Because of drop -outs, the NSAID group (n=15 : 7 men, 8 women) and the exercise group (n =18 : 8 men, 10 women) were finally analyzed. We applied a visual analog scale, Roland-Morris disability scores, and the 36 -Item Short Form Health Survey. We used a paired ttest for within -group analyses and an unpaired t -test for between -group analyses. Pain relief was achieved after 3 months of pharmacotherapy or exercise. Quality of life improved only in the exercise group. Recovery outcomes for the two groups were not significantly different. Efficacy of exercise therapy for strictly defined low back pain was almost equivalent to that of pharmacotherapy and provided better quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Therapeutic efficacy of nonsteroidal anti-inflammatory drug therapy versus exercise therapy in patients with chronic nonspecific low back pain: a prospective study

Takahashi

Omata

Iwabuchi

et al. 2017

FJMS

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“…At present, there are no reliability studies that exist for detecting clinical central or lateral stenosis. Only a self-reported history questionnaire has proven successful as a diagnostic tool for lumbar spinal stenosis 45 . In the present pilot study, the number of patients was small, which thus -ings.…”

Section: Discussionmentioning

confidence: 99%

Inter-tester Reliability in Classifying Acute and Subacute Low Back Pain Patients into Clinical Subgroups: A Comparison of Specialists and Non-Specialists. A Pilot Study

Paatelma¹,

Karvqnen²,

Heinqnen³

2009

Journal of Manual & Manipulative Therapy

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Many systems have been suggested for classifying low back pain (LBP); the most commonly used among physiotherapists involves a pathoanatomical/pathophysiological tissue classification system. Few studies have examined whether this form of classification of LBP disorders can be performed in a reliable manner between specialists with advanced training, or between specialists with advanced training and non-specialists who lack advanced training. The purpose of this paper was to examine the inter-tester reliability of two specialists, and the ability of a specialist and non-specialist to independently classify patients with LBP, utilizing clinical tests and history-based classification methods after a short educational course on the classification system. Subjects were acute or sub-acute patients with LBP who visited their occupational healthcare or municipal healthcare center. Inter-tester reliability between the specialist and non-specialists was at almost the same level: overall Kappa 0.60 (95%CI; 0.40 to 0.85), overall agreement 70%, as between the two specialists: overall Kappa 0.65 (95%CI; 0.33-0.86), overall agreement 77%. The findings suggest that a short educational course can provide rather reliable examination tools to allow non-specialized physiotherapists to classify patients according to tissue origination.

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“…Four recent studies [30][31][32][33] have examined symptomatic presentation of patients with LSS, and the results of these studies were reviewed in a meta-analysis (n = 741) by Suri and colleagues. 4 The study population was not limited to patients with specific reports of intermittent claudication; rather, patients presenting with LBP and/or lower extremity pain were included.…”

Section: Discussionmentioning

confidence: 99%

The reliability of differentiating neurogenic claudication from vascular claudication based on symptomatic presentation

Nadeau

Rosas‐Arellano

Gurr

et al. 2013

CJS

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Background: Intermittent claudication can be neurogenic or vascular. Physicians use a profile based on symptom attributes to differentiate the 2 types of claudication, and this guides their investigations for diagnosis of the underlying pathology. We evaluated the validity of these symptom attributes in differentiating neurogenic from vascular claudication. Methods:Patients with a diagnosis of lumbar spinal stenosis (LSS) or peripheral vascular disease (PVD) who reported claudication answered 14 questions characterizing their symptoms. We determined the sensitivity, specificity and positive and negative likelihood ratios (PLR and NLR) for neurogenic and vascular claudication for each symptom attribute. Results:We studied 53 patients. The most sensitive symptom attribute to rule out LSS was the absence of "triggering of pain with standing alone" (sensitivity 0.97, NLR 0.050). Pain alleviators and symptom location data showed a weak clinical significance for LSS and PVD. Constellation of symptoms yielded the strongest associations: patients with a positive shopping cart sign whose symptoms were located above the knees, triggered with standing alone and relieved with sitting had a strong likelihood of neurogenic claudication (PLR 13). Patients with symptoms in the calf that were relieved with standing alone had a strong likelihood of vascular claudication (PLR 20.0). Conclusion:The classic symptom attributes used to differentiate neurogenic from vascular claudication are at best weakly valid independently. However, certain constellation of symptoms are much more indicative of etiology. These results can guide general practitioners in their evaluation of and investigation for claudication.Contexte : La claudication intermittente peut avoir une étiologie neurogène ou vasculaire. Les médecins utilisent un profil fondé sur les particularités des symptômes pour distinguer l'une de l'autre et ceci oriente leur choix des méthodes de diagnostic de la pathologie sous-jacente. Nous avons évalué la validité de ces particularités des symptômes utilisées pour distinguer la claudication d'origine neurogène de la claudication d'origine vasculaire. Méthodes :Des patients atteints d'une sténose spinale lombaire (SSL) ou d'une maladie vasculaire périphérique (MVP) avérées qui se plaignaient de claudication ont répondu à 14 questions afin de caractériser leurs symptômes. Nous avons déterminé la sensibilité, la spécificité et les rapports de probabilité positifs et négatifs (RPP et RPN) à l'égard de la claudication neurogène ou vasculaire pour chacune des particularités des symptômes.Résultats : Notre étude a regroupé 53 patients. La particularité des symptômes dotée de la sensibilité la plus élevée pour ce qui est d'écarter le diagnostic de SSL a été l'absence de « déclenchement de la douleur à la simple station debout » (sensibilité 0,97; RPN 0,050). Les données sur ce qui soulageait la douleur et sur la localisation des symptômes ont eu une faible portée clinique en ce qui a trait à la SSL et à la MVP. La présence d'une constellati...

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A diagnostic support tool for lumbar spinal stenosis: a self-administered, self-reported history questionnaire

Cited by 78 publications

References 16 publications

Therapeutic efficacy of nonsteroidal anti-inflammatory drug therapy versus exercise therapy in patients with chronic nonspecific low back pain: a prospective study

Therapeutic efficacy of nonsteroidal anti-inflammatory drug therapy versus exercise therapy in patients with chronic nonspecific low back pain: a prospective study

Inter-tester Reliability in Classifying Acute and Subacute Low Back Pain Patients into Clinical Subgroups: A Comparison of Specialists and Non-Specialists. A Pilot Study

The reliability of differentiating neurogenic claudication from vascular claudication based on symptomatic presentation

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