Abstract
BackgroundBeside symptoms and clinical signs radiological findings are crucial in the diagnosis of lumbar spinal stenosis (LSS). We investigate which quantitative radiological signs are described in the literature and which radilogical criteria are used to establish inclusion criteria in clincical studies evaluating different treatments in patients with lumbar spinal stenosis.MethodsA literature search was performed in Medline, Embase and the Cochrane library to identify papers reporting on radiological criteria to describe LSS and systematic reviews investigating the effects of different treatment modalities.Results25 studies reporting on radiological signs of LSS and four systematic reviews related to the evaluation of different treatments were found. Ten different parameters were identified to quantify lumbar spinal stenosis. Most often reported measures for central stenosis were antero-posterior diameter (< 10 mm) and cross-sectional area (< 70 mm2) of spinal canal. For lateral stenosis height and depth of the lateral recess, and for foraminal stenosis the foraminal diameter were typically used. Only four of 63 primary studies included in the systematic reviews reported on quantitative measures for defining inclusion criteria of patients in prognostic studies.ConclusionsThere is a need for consensus on well-defined, unambiguous radiological criteria to define lumbar spinal stenosis in order to improve diagnostic accuracy and to formulate reliable inclusion criteria for clinical studies.
Highlights
Beside symptoms and clinical signs radiological findings are crucial in the diagnosis of lumbar spinal stenosis (LSS)
In a recent review Genevay [8] reported that researchers used quite different combinations of symptoms, clinical signs and radiological criteria to set up inclusion criteria for trials in patients with lumbar spinal stenosis
After reading the publications 7 papers fulfilled the inclusion criteria, and 60 papers were excluded because they did not report on any quantitative radiological sign of lumbar spinal stenosis
Summary
Beside symptoms and clinical signs radiological findings are crucial in the diagnosis of lumbar spinal stenosis (LSS). In clinical medicine lumbar spinal stenosis is defined as “buttock or lower extremity pain, which may occur with or without low back pain, associated with diminished space available for the neural and vascular elements in the lumbar spine”[2]. This definition includes two aspects: morphological abnormalities and clinical manifestations, neurogenic claudication, caused by the somatic anomaly. In a recent review Genevay [8] reported that researchers used quite different combinations of symptoms, clinical signs and radiological criteria to set up inclusion criteria for trials in patients with lumbar spinal stenosis. The North American Spine Society states in their guideline that imaging is the key noninvasive test for lumbar spinal stenosis, but they provide no radiological criteria for stenosis in these guidelines [2]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
