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A systematic review of developmental lumbar spinal stenosis

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European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

To systematically evaluate any consensus for the etiology, definition, presentation and outcomes of developmental lumbar spinal stenosis (DLSS).

Methods

A comprehensive literature search was undertaken by 2 independent reviewers with PubMed, Ovid, and Web of Science to identify all published knowledge on DLSS. Search terms included “developmental spinal stenosis” or “congenital spinal stenosis” and “lumbar”. The inclusion criteria were English clinical studies with sample size larger than 8, articles examining the etiology, diagnostic criteria, surgical outcomes of DLSS, and its association with other spinal pathologies. Articles that did not specify a developmental component were excluded. The GRADE approach was used to assess their quality of evidence.

Results

The initial database review found 404 articles. Twenty articles with moderate to very low quality met the inclusion criteria for analysis. The bony canal diameter was significantly shorter in patients with DLSS than normal subjects. In addition, the risk of re-operation on adjacent levels (21.7%) was high which could be explained by multi-level stenosis. However, there was a lack of consensus on the methodology of diagnosing DLSS and on its specific surgical techniques.

Conclusion

Multi-level stenosis and re-operation at adjacent levels are especially common with DLSS. Identification of these individuals provides better prognostication after surgery. However, current literature provides few consensus on its definition and the required surgical approach. Besides, there are limited reports of its etiology and association with other spinal pathologies. Due to these limitations, standardizing the definition of DLSS and investigating its etiology and expected clinical course are necessary.

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Funding

Supported by the Master of Research in Medicine (MRes) programme at the University of Hong Kong and the AOSpine Asia Pacific Regional Grant.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong SAR, China

    Marcus Kin Long Lai, Prudence Wing Hang Cheung & Jason Pui Yin Cheung

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  1. Marcus Kin Long Lai
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  2. Prudence Wing Hang Cheung
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  3. Jason Pui Yin Cheung
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Contributions

Lai Kin Long Marcus was involved in title, abstract and full-text screening, drafting the paper, approval of submitted and final versions. Prudence Wing Hang Cheung was involved in title, abstract and full-text screening, approval of submitted and final versions. Jason Pui Yin Cheung contributed to the study design, supervision, revising the paper, approval of submitted and final versions.

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Correspondence to Jason Pui Yin Cheung.

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Lai, M.K.L., Cheung, P.W.H. & Cheung, J.P.Y. A systematic review of developmental lumbar spinal stenosis. Eur Spine J 29, 2173–2187 (2020). https://doi.org/10.1007/s00586-020-06524-2

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