Format

Send to:

Choose Destination
See comment in PubMed Commons below
Spine (Phila Pa 1976). 2016 Feb 1. [Epub ahead of print]

Consensus on the Clinical Diagnosis of Lumbar Spinal Stenosis: Results of an International Delphi Study.

Author information

  • 1*Mount Royal University, Canada (Chair of Taskforce) †Zurich University of Applied Sciences, Switzerland (Co-Chair) ‡Dartmouth University, USA §Stanford University, USA ¶University of Adelaide, Australia ||University of Hong Kong, Hong Kong **University of Calgary, Canada ††Asklepios Gemeinsam für Gesundheit, Germany ‡‡Canadian Memorial Chiropractic College, Canada §§University of Pittsburgh, USA ¶¶University of Michigan, USA ||||University Hospital of Lausanne, Switzerland ***Queen Mary Hospital, Hong Kong †††Spine Center, Schulthess Klinik, Switzerland ‡‡‡University of Berne, Switzerland §§§Wharfedale General Hospital, United Kingdom ¶¶¶University of Alberta, Canada ||||||Yeungnam University, South Korea ****Chiba University, Japan ††††University of Michigan. ‡‡‡‡University of Alberta, Canada.

Abstract

STUDY DESIGN:

Delphi.

OBJECTIVE:

Obtain an expert consensus on which history factors are most important in the clinical diagnosis of LSS.

SUMMARY OF BACKGROUND DATA:

Lumbar spinal stenosis (LSS) is a poorly defined clinical syndrome. Criteria for defining LSS are needed and should be informed by the experience of expert clinicians.

METHODS:

Phase 1 (Delphi Items): 20 members of the International Taskforce on the Diagnosis and Management of LSS confirmed a list of 14 history items. An on-line survey was developed that permits specialists to express the logical order in which they consider the items, and the level of certainty ascertained from the questions. Phase 2 (Delphi Study) Round 1: Survey distributed to members of the International Society for the Study of the Lumbar Spine. Round 2: Meeting of 9 members of Taskforce where consensus was reached on a final list of 10 items. Round 3: Final survey was distributed internationally. Phase 3: Final Taskforce consensus meeting.

RESULTS:

279 clinicians from 29 different countries, with a mean of 19 (±SD: 12) years in practice participated. The six top items were "leg or buttock pain while walking", "flex forward to relieve symptoms", "feel relief when using a shopping cart or bicycle", "motor or sensory disturbance while walking", "normal and symmetric foot pulses", "lower extremity weakness" and "low back pain". Significant change in certainty ceased after 6 questions at 80% (p < .05).

CONCLUSIONS:

This is the first study to reach an international consensus on the clinical diagnosis of LSS, and suggests that within six questions clinicians are 80% certain of diagnosis. We propose a consensus-based set of "7 history items" that can act as a pragmatic criterion for defining LSS in both clinical and research settings, which in the long-term may lead to more cost-effective treatment, improved health-care utilization and enhanced patient outcomes.

LEVEL OF EVIDENCE:

2.

PMID:
26839989
[PubMed - as supplied by publisher]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk