Consensus for Statements Regarding a Definition for Spinal Osteoarthritis for Use in Research and Clinical Practice: A Delphi Study

Abstract

Objective To determine consensus among an international, multidisciplinary group of experts regarding definitions of spinal osteoarthritis for research and for clinical practice. Methods A 15‐member, multidisciplinary steering committee generated 117 statements for a 3‐round Delphi study. Experts in back pain and/or osteoarthritis were identified and invited to participate. In round 1, participants could propose additional statements for voting. All statements were rated on a 1–9 Likert scale, and consensus was set at ≥70% of respondents agreeing or disagreeing with the statement and <15% of respondents providing the opposite response. Results In total, 255 experts from 11 different professional backgrounds were invited. From 173 available experts, 116 consented to participate. In round 1, 103 participants completed the survey, followed by 85 of 111 participants in round 2 (77%) and 87 of 101 participants in round 3 (86%). One‐third of participants were from Europe (30%), most were male (58%), one‐fifth were physical therapists (21%), and over one‐third had been in their profession for 11–20 years (35%). Of 131 statements, consensus was achieved for 71 statements (54%): 53 in agreement (75%) and 18 in disagreement (25%). Conclusion Although there was consensus for statements for definitions of spinal osteoarthritis that were analogous to definitions of osteoarthritis in appendicular joints, a future definition still needs refinement. Importantly, this Delphi highlighted that a future definition should be considered across a spectrum of structural changes and patient symptoms and expressed on a progressive scale.

Myofascial Pain as an Unseen Comorbidity in Osteoarthritis

“…However, efforts have been recently made toward meeting expert consensus. 54 Hong et al 41 defined spine OA in their study based on radiography structural abnormalities in the cervical spine, including disk and facet joints. Evidence has supported the role of facet joint OA in chronic MPS.…”

Association Between Clinical Findings And The Presence Of Lumbar Spine Osteoarthritis Imaging Features: A Systematic Review

“…This underlines the need for agreed criteria for symptomatic and structural spinal osteoarthritis, as highlighted by a recent international consensus study. 5 Additionally, guidelines on how to universally define and assess various clinical and imaging features related to spinal osteoarthritis would be useful to ease the research in this field and to possibly identify potential subgroups regarding etiology, prognosis, and treatment.…”

“…In 2021, a Delphi study was conducted to reach an international consensus on statements regarding definitions of spinal osteoarthritis. 5 A high proportion of agreement was found for the statement "separate definitions for structural and symptomatic spinal osteoarthritis are needed" for research and clinical practice (94% and 88% respectively). In addition, a consensus was reached on the following clinical features as suggestive of symptomatic spinal osteoarthritis: spinal pain duration, spinal pain intensity, limitations in physical functioning, and self-reported spinal morning stiffness.…”

“…Hence, this systematic review aimed to determine the association present between clinical findings and imaging features that are potential indicators of lumbar spine osteoarthritis in patients with LBP. The clinical findings were selected among those for which there was consensus or uncertainty in the recent aforementioned Delphi study, 5 while the presence of imaging features possibly associated with lumbar spine osteoarthritis was investigated using different imaging modalities (i.e., radiography, MRI, CT-scan).…”

Associations between comorbid lumbar spinal stenosis symptoms and treatment outcomes in 6,813 patients with knee or hip osteoarthritis following a patient education and exercise therapy program

“…The shared degenerative etiology between LSS, knee, and hip OA [ 6 , 7 ] has led to suggestions that LSS can be considered as lumbar spine OA with resultant neurological symptomology in one or both lower extremities [ 8 ]. Therefore, co-occurrence with knee or hip OA as part of a multi-joint or generalized OA presentation could be expected.…”