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Open Access Highly Accessed Research article

Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis: a systematic literature review

Johann Steurer1*, Simon Roner1, Ralph Gnannt2, Juerg Hodler2 and On behalf of the LumbSten Research Collaboration, Zurich, Switzerland

Author Affiliations

1 Horten Centre for patient oriented research and knowledge transfer, University Zurich, Raemistrasse 100, CH 8091 Zurich, Switzerland

2 Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH 8091 Zurich, Switzerland

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BMC Musculoskeletal Disorders 2011, 12:175  doi:10.1186/1471-2474-12-175

Published: 28 July 2011

Abstract

Background

Beside 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.

Methods

A 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.

Results

25 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.

Conclusions

There 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.