Classification Criteria for Neurogenic Claudication Caused by Lumbar Spinal Stenosis

peer reviewedBACKGROUND Classification criteria are recommended for diseases that lack highly specific biomarkers in order to improve homogeneity in clinical research. Since imaging evidence of lumbar spinal stenosis (LSS) or lumbar disc herniations (LDH) may not be associated with symptoms, clinical classification criteria based upon patient symptoms and physical examination findings are required. This study sought to develop a set of criteria identifying patients with neurogenic claudication (NC) caused by LSS and patient with radicular pain (RP) caused by LDH. This abstract reports the results concerning NC caused by LSS. METHODS Phase 1: Nineteen spine specialists (clinicians and researchers) from 8 countries participated in a Delphi process, using an internet program, to rank symptoms and signs which suggest LSS as the cause of NC or DH as the cause of RP. Phase 2: Nineteen different spine specialists (surgeons and non-surgeons) from 5 countries recruited patients during office visits and classify them with a high degree of confidence as having with either: 1) NC caused by LSS 2) RP caused by LDH or 3) non-specific low back pain (NSLBP) with non-specific leg pain radiation. Patients completed survey items and specialists documented examination signs. Signs and symptoms present in ≥ 10 patients were analyzed by using Generalized Estimating Equations (GEE). Patients with NC caused by LSS or NSLBP served as controls. Items with p