Does This Older Adult With Lower Extremity Pain Have the Clinical Syndrome of Lumbar Spinal Stenosis

摘要: Context The clinical syndrome of lumbar spinal stenosis (LSS) is a common diagnosis in older adults presenting with lower extremity pain. Objective To systematically review the accuracy examination for LSS. Data Sources MEDLINE, EMBASE, and CINAHL searches articles published from January 1966 to September 2010. Study Selection Studies were included if they contained adequate data on history physical diagnosing LSS, using reference standard expert opinion radiographic or anatomic confirmation. Extraction Two authors independently reviewed each study determine eligibility, extract data, appraise levels evidence. Synthesis Four studies evaluating 741 patients identified. Among pain, likelihood LSS was increased individuals than 70 years (likelihood ratio [LR], 2.0; 95% confidence interval [CI], 1.6-2.5), decreased those younger 60 (LR, 0.40; CI, 0.29-0.57). most useful symptoms increasing having no pain when seated 7.4; 1.9-30), improvement bending forward 6.4; 4.1-9.9), presence bilateral buttock leg 6.3; 3.1-13), neurogenic claudication 3.7; 2.9-4.8). Absence 0.23; 0.17-0.31) diagnosis. A wide-based gait 13; 1.9-95) abnormal Romberg test result 4.2; 1.4-13) score 7 higher diagnostic support tool including findings 3.3; 2.7-4.0), while made much less likely 0.10; 0.06-0.16). Conclusions requires appropriate picture findings. are individual Combinations identifying who unlikely have