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

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

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Supplementary file 1

Search strategy in EMBASE, MEDLINE and CINAHL (PDF 180 kb)

Supplementary file 2

Risk-of-bias assessment tool (PDF 225 kb)

Supplementary material 3 (PPTX 1569 kb)

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Jensen, R.K., Jensen, T.S., Koes, B. et al. Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis. Eur Spine J 29, 2143–2163 (2020). https://doi.org/10.1007/s00586-020-06339-1

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Keywords

  • Lumbar spinal stenosis
  • Neurogenic claudication
  • Prevalence
  • MRI
  • Review
  • Meta-analysis