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8. Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis

Author

Rikke Krüger Jensen, Tue Secher Jensen, Bart W. Koes, Jan Hartvigsen, and General Practice

Subjects
Adult, medicine.medical_specialty, Population, Neurogenic claudication, Review, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Spinal Stenosis, Internal medicine, medicine, Prevalence, Humans, Orthopedics and Sports Medicine, Medical diagnosis, education, Aged, 030222 orthopedics, education.field_of_study, Lumbar Vertebrae, Primary Health Care, business.industry, Lumbar spinal stenosis, medicine.disease, Meta-analysis, Radiological weapon, Surgery, Neurosurgery, medicine.symptom, business, 030217 neurology & neurosurgery, MRI
Abstract

Purpose: To estimate the prevalence of degenerative lumbar spinal stenosis (LSS) in adults, identified by clinical symptoms and/or radiological criteria. Methods: Systematic review of the literature. Pooled prevalence estimates by care setting and clinical or radiological diagnostic criteria were calculated and plotted [PROSPERO ID: CRD42018109640]. Results: In total, 41 papers reporting on 55 study samples were included. The overall risk of bias was considered high in two-thirds of the papers. The mean prevalence, based on a clinical diagnosis of LSS in the general population, was 11% (95% CI 4–18%), 25% (95% CI 19–32%) in patients from primary care, 29% (95% CI 22–36%) in patients from secondary care and 39% (95% CI 39–39%) in patients from mixed primary and secondary care. Evaluating the presence of LSS based on radiological diagnosis, the pooled prevalence was 11% (95% CI 5–18%) in the asymptomatic population, 38% (95% CI − 10 to 85%) in the general population, 15% (95% CI 13–18%) in patients from primary care, 32% (95% CI 22–41%) in patients from secondary care and 21% (95% CI 16–26%) in a mixed population from primary and secondary care. Conclusions: The mean prevalence estimates based on clinical diagnoses vary between 11 and 39%, and the estimates based on radiological diagnoses similarly vary between 11 and 38%. The results are based on studies with high risk of bias, and the pooled prevalence estimates should therefore be interpreted with caution. With an growing elderly population, there is a need for future low risk-of-bias research clarifying clinical and radiological diagnostic criteria of lumbar spinal stenosis. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]

Published
2020