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

Details

Serval ID
serval:BIB_4CF5F7B2FD3D
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
ISSLS Prize Winner: Consensus on the Clinical Diagnosis of Lumbar Spinal Stenosis: Results of an International Delphi Study.
Journal
Spine
Author(s)
Tomkins-Lane C., Melloh M., Lurie J., Smuck M., Battié M.C., Freeman B., Samartzis D., Hu R., Barz T., Stuber K., Schneider M., Haig A., Schizas C., Cheung J.P., Mannion A.F., Staub L., Comer C., Macedo L., Ahn S.H., Takahashi K., Sandella D.
ISSN
1528-1159 (Electronic)
ISSN-L
0362-2436
Publication state
Published
Issued date
01/08/2016
Peer-reviewed
Oui
Volume
41
Number
15
Pages
1239-1246
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Delphi.
The aim of this study was to obtain an expert consensus on which history factors are most important in the clinical diagnosis of lumbar spinal stenosis (LSS).
LSS is a poorly defined clinical syndrome. Criteria for defining LSS are needed and should be informed by the experience of expert clinicians.
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 online 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.
A total of 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 six questions at 80% (P < .05).
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 "seven 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.
2.

Keywords
Awards and Prizes, Consensus, Delphi Technique, Humans, Low Back Pain/diagnosis, Low Back Pain/physiopathology, Lumbar Vertebrae/surgery, Nervous System Diseases/diagnosis, Spinal Stenosis/diagnosis, Spinal Stenosis/therapy, Surveys and Questionnaires
Pubmed
Create date
16/02/2016 17:19
Last modification date
20/08/2019 14:01
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