Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis : consensus and results of an international Delphi study

Tomkins-Lane, Christy; Melloh, Markus; Wong, Arnold

doi:10.1007/s00586-020-06481-w

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis : consensus and results of an international Delphi study
Authors:	Tomkins-Lane, Christy Melloh, Markus Wong, Arnold
et. al:	No
DOI:	10.1007/s00586-020-06481-w
Published in:	European Spine Journal
Volume(Issue):	29
Issue:	9
Page(s):	2188
Pages to:	2197
Issue Date:	2020
Publisher / Ed. Institution:	Springer
ISSN:	0940-6719 1432-0932
Language:	English
Subjects:	Consensus; Diagnosis; Lumbar stenosis; MRI; Neurologic
Subject (DDC):	616.7: Diseases of musculoskeletal system and orthopaedics
Abstract:	Purpose: Reach a consensus on which diagnostic tests are most important in confrming the clinical diagnosis of lumbar spinal stenosis (LSS). Methods: Phase 1: 22 members of the International Taskforce on the Diagnosis and Management of LSS confrmed 35 diagnostic items. An on-line survey was developed that allows experts to express the logical order in which they consider the diagnostic tests, and the level of certainty ascertained from each test. Phase 2, Round 1: Survey distributed to members of the International Society for the Study of the Lumbar Spine. Round 2: Meeting of 15 members of Taskforce defned fnal list of 10 items. Round 3: Survey was distributed internationally, followed by Taskforce consensus. Results: Totally, 432 clinicians from 28 diferent countries participated. Certainty of the diagnosis was 60% after selecting the frst test and signifcant change in certainty ceasing after eight items at 90.8% certainty (p<0.05). The most frequently selected tests included MRI/CT scan, neurological examination and walking test with gait observation. The diagnostic test selected most frequently as the frst test was neurological examination. Conclusions: This is the frst study to reach an international consensus on which diagnostic tests should be used in the clinical diagnosis of LSS. The fnal recommendation includes three core diagnostic items: neurological examination, MRI/CT and walking test with gait observation. The Taskforce also recommends 3 ‘rule out’ tests: foot pulses/ABI, hip examination and test for cervical myelopathy. If applied, this core set of diagnostic tests can standardize outcomes and improve clinical care of LSS globally.
URI:	https://digitalcollection.zhaw.ch/handle/11475/21179
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Public Health (IPH)
Appears in collections:	Publikationen Gesundheit

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Tomkins-Lane, C., Melloh, M., & Wong, A. (2020). Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis : consensus and results of an international Delphi study. European Spine Journal, 29(9), 2188–2197. https://doi.org/10.1007/s00586-020-06481-w

Tomkins-Lane, C., Melloh, M. and Wong, A. (2020) ‘Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis : consensus and results of an international Delphi study’, European Spine Journal, 29(9), pp. 2188–2197. Available at: https://doi.org/10.1007/s00586-020-06481-w.

C. Tomkins-Lane, M. Melloh, and A. Wong, “Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis : consensus and results of an international Delphi study,” European Spine Journal, vol. 29, no. 9, pp. 2188–2197, 2020, doi: 10.1007/s00586-020-06481-w.

TOMKINS-LANE, Christy, Markus MELLOH und Arnold WONG, 2020. Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis : consensus and results of an international Delphi study. European Spine Journal. 2020. Bd. 29, Nr. 9, S. 2188–2197. DOI 10.1007/s00586-020-06481-w

Tomkins-Lane, Christy, Markus Melloh, and Arnold Wong. 2020. “Diagnostic Tests in the Clinical Diagnosis of Lumbar Spinal Stenosis : Consensus and Results of an International Delphi Study.” European Spine Journal 29 (9): 2188–97. https://doi.org/10.1007/s00586-020-06481-w.

Tomkins-Lane, Christy, et al. “Diagnostic Tests in the Clinical Diagnosis of Lumbar Spinal Stenosis : Consensus and Results of an International Delphi Study.” European Spine Journal, vol. 29, no. 9, 2020, pp. 2188–97, https://doi.org/10.1007/s00586-020-06481-w.