The validity of a clinical test for the diagnosis of lumbar spinal stenosis

Dobbs, Robert M.; May, Stephen; Hope, Philip

doi:10.1016/j.math.2016.05.332

Cited by 9 publications

(5 citation statements)

References 50 publications

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“…Some papers did not describe how severity was classified while others used different definitions and cut-off points. However, except for two study populations [24,49], all the results showed that LSS classified as severe was less prevalent than classifications of mild/moderate LSS.…”

Section: Classification Of Severity and Radiological Anatomical Locatmentioning

confidence: 91%

Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis

et al. 2020

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To estimate the prevalence of degenerative lumbar spinal stenosis (LSS) in adults, identified by clinical symptoms and/or radiological criteria. Method Systematic review of the literature. Pooled prevalence estimates by care setting and clinical or radiological diagnostic criteria were calculated and plotted. [PROSPERO ID: CRD42018109640] Results In total, 41 papers reporting on 55 study samples were included. The overall risk-of-bias was considered high in two-thirds of the papers. The mean prevalence, based on a clinical diagnosis of LSS in the general population was 11% (95% CI: 4-18%), 25% (95% CI: 19-32%) in patients from primary care, 29% (95% CI: 22-36%) in patients from secondary care and 39% (95% CI: 39-39%) in patients from mixed primary and secondary care. Evaluating the presence of LSS based on radiological diagnosis, the pooled prevalence was 11% (95% CI: 5-18%) in the asymptomatic population, 38% (95% CI:-10-85%) in the general population, 15% (95% CI: 13-18%) in patients from primary care, 32% (95% CI: 22-41%) in patients from secondary care and 21% (95% CI: 16-26%) in a mixed population from primary and secondary care. Conclusions The mean prevalence estimates based on clinical diagnoses vary between 11% and 39% and the estimates based on radiological diagnoses similarly vary between 11% and 38%. The results are based on studies with high risk-of-bias and the pooled prevalence estimates should therefore be interpreted with caution. With an growing elderly population there is a need for future low risk-of-bias research clarifying clinical and radiological diagnostic criteria of lumbar spinal stenosis.

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Section: Classification Of Severity and Radiological Anatomical Locatmentioning

confidence: 91%

Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis

et al. 2020

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“…5 A single UK based study (n=30) estimated the prevalence of NC amongst patients (50 years and over) presenting with back and leg pain to primary care to be 87%. 6 Little is also known about the relationship between BP and different patterns of leg pain and adverse health states including frailty, mobility decline, falls, poor sleep quality and incontinence. BP in older adults is associated with frailty, falls and immobility.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Back and Leg Pain and the Cross-sectional Association With Adverse Health Outcomes in Community Dwelling Older Adults in England

Williamson

Sanchez‐Santos

Morris

et al. 2020

Spine

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Study Design: Cross-sectional analysis of the Oxford Pain, Activity and Lifestyle (OPAL) Cohort Study Summary of background data: Epidemiological data describing the prevalence of back pain (BP) and leg pain in older adults in England is lacking.Objective: To assess the prevalence of BP and leg pain and determine their relationship with adverse health states among older adults in England.Methods: 5,304 community-dwelling adults (aged 65-100 years) enrolled in the OPAL cohort study who provided data on BP and leg pain were included. Participants were classified into four groups based on reports of back and leg pain: 1) no BP, 2) BP only, 3) BP and leg pain which was likely to be neurogenic claudication (NC), 4) and BP and leg pain which was not NC. Adverse health states were frailty, falls, mobility decline, low walking confidence, poor sleep quality and urinary incontinence. We collected demographic and socioeconomic information, health-related quality of life and existing health conditions, and estimated the association between BP presentations and adverse health states using regression analysis.Results: Thirty-four percent of participants (1,786/5,304) reported BP only, 11.2% (n=594/5,304) reported BP and NC and 8.3% (n=441/5,304) reported BP and non-NC leg pain. Participants with BP had worse quality of life compared to those without BP. All BP presentations were significantly associated with adverse health states. Those with NC were most affected. In particular, there was greater relative risk (RR) of low walking confidence ), frailty ) and mobility decline (RR 95%CI 1.74 [1.54-1.97]) compared to no BP. Conclusion:Back and leg pain is a common problem for older adults and associated with reduced quality of life and adverse health states. Findings suggest a need to develop more effective treatment for older adults with back pain especially for those with neurogenic claudication.

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“…This suggests that the presence of neurological deficits might be used for ruling in the diagnosis of LSS. There is limited and highly inconsistent evidence to support the use of the Lumbar Extension Test and of the Straight Leg Raising Test for the diagnosis of LSS [51,52,56].…”

Section: Physical Examinationmentioning

confidence: 99%

Diagnosis Value of Patient Evaluation Components Applicable in Primary Care Settings for the Diagnosis of Low Back Pain: A Scoping Review of Systematic Reviews

Mathieu

Pasquier

Descarreaux

et al. 2023

JCM

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Low back pain ranks as the leading cause of years lived with disability worldwide. Although best practice guidelines share a consistent diagnostic approach for the evaluation of patients with low back pain, confusion remains as to what extent patient history and physical examination findings can inform management strategies. The aim of this study was to summarize evidence investigating the diagnostic value of patient evaluation components applicable in primary care settings for the diagnosis of low back pain. To this end, peer-reviewed systematic reviews were searched in MEDLINE, CINAHL, PsycINFO and Cochrane databases from 1 January 2000 to 10 April 2023. Paired reviewers independently reviewed all citations and articles using a two-phase screening process and independently extracted the data. Of the 2077 articles identified, 27 met the inclusion criteria, focusing on the diagnosis of lumbar spinal stenosis, radicular syndrome, non- specific low back pain and specific low back pain. Most patient evaluation components lack diagnostic accuracy for the diagnosis of low back pain when considered in isolation. Further research is needed to develop evidence-based and standardized evaluation procedures, especially for primary care settings where evidence is still scarce.

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The validity of a clinical test for the diagnosis of lumbar spinal stenosis

Cited by 9 publications

References 50 publications

Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis

Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis

The Prevalence of Back and Leg Pain and the Cross-sectional Association With Adverse Health Outcomes in Community Dwelling Older Adults in England

Diagnosis Value of Patient Evaluation Components Applicable in Primary Care Settings for the Diagnosis of Low Back Pain: A Scoping Review of Systematic Reviews

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