Diagnostic Tests for Lumbar Spinal Stenosis
- Dr. Shawn Thistle
Lumbar spinal stenosis (LSS) is a degenerative condition that may lead to low back and leg pain, as well as significant functional limitations and disability. This is a condition all chiropractors will encounter on a regular basis.
The prevalence and economic burden of LSS is increasing globally (and will continue to do so as the population ages), yet there is no gold standard for its diagnosis, which is currently based on a combination of information gathered from the patient’s history, physical examination, imaging, and other diagnostic studies.
Given that there were no clinical guidelines regarding the diagnostic criteria for LSS, the authors of this study considered that a consensus-based set of diagnostic criteria for LSS was necessary to refine outcomes assessment and lead to optimized clinical care. They utilized the Delphi method, which is a process whereby the results of multiple rounds of questionnaires are sent to a panel of experts (in this case, globally).
In combination with their prior study that resulted in a consensus-based list of historical items/questions that clinicians should use in practice when LSS is suspected (included below), clinicians now have a complete approach to assessing and diagnosing this condition…enjoy!
THIS WEEK'S RESEARCH REVIEW: “Diagnostic Tests for Lumbar Spinal Stenosis”
This paper was published in the European Spine Journal (2020) and this Review is posted in Recent Reviews, Lumbar Spinal Stenosis and the 2021 Archive.
Most relevant historical questions to ask when you suspect lumbar spinal stenosis/claudication:
- Does the patient have leg or buttock pain while walking?
- Does the patient flex forward to relive symptoms?
- Does the patient feel relief when using a shopping cart or bicycle?
- Does the patient have motor or sensory disturbance while walking?
- Are the pulses in the foot present and symmetric?
- Does the patient have lower extremity weakness?
- Does the patient have low back pain?