Sugioka et al reported a score for identifying lateral spinal stenosis (LSS) based on clinical findings. This can help to identify patients who may benefit from more aggressive management. The authors are from Kyoto University and Fukushima Medical University.
Patient selection: age > 20 years with pain or numbness in lower extremities (including buttocks)
Parameters:
(1) age in years
(2) time from onset
(3) symptoms improve when bending forward
(4) symptoms improve when bending backward
(5) symptoms exacerbated while standing up
(6) intermittent claudication
(7) urinary incontinence
|
Parameters |
Finding |
Points |
|
age in years |
< 60 years |
0 |
|
|
60 to 70 years |
2 |
|
|
> 70 years |
3 |
|
time from onset |
<= 6 months |
0 |
|
|
> 6 months |
1 |
|
symptoms improve if bending forward |
no |
0 |
|
|
yes |
2 |
|
symptoms improve if bending backward |
no |
0 |
|
|
yes |
-2 |
|
symptoms exacerbated while standing up |
no |
0 |
|
|
yes |
2 |
|
intermittent claudication |
no |
0 |
|
|
yes |
1 |
|
urinary incontinence |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: -2
• maximum score: 10
• The higher the score the greater the risk for lateral spinal stenosis.
|
Score |
Quartile |
Percent LSS |
|
<= 2 |
first |
16% |
|
3 or 4 |
second |
42% |
|
5 or 6 |
third |
54% |
|
7 to 10 |
fourth |
67% |
Performance:
• The area under the ROC curve was 0.77 in derivation set and 0.67 in the validation set.
• The sensitivity was 0.81 in the derivation set and 0.75 in the validation set.
• The specificity was 0.58 in the derivation set and 0.51 in the validation set.
Specialty: Surgery, orthopedic
