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



To estimate the prevalence of degenerative lumbar spinal stenosis (LSS) in adults, identified by clinical symptoms and/or radiological criteria.


Systematic review of the literature. Pooled prevalence estimates by care setting and clinical or radiological diagnostic criteria were calculated and plotted [PROSPERO ID: CRD42018109640].


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.


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.

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  1. 1.

    Porter RW (1996) Spinal stenosis and neurogenic claudication. Spine (Phila Pa 1976) 21(17):2046–2052

    CAS  Article  Google Scholar 

  2. 2.

    Iversen MD, Katz JN (2001) Examination findings and self-reported walking capacity in patients with lumbar spinal stenosis. Phys Ther 81(7):1296–1306

    CAS  Article  Google Scholar 

  3. 3.

    Tomkins-Lane C, Melloh M, Lurie J, Smuck M, Freeman B, Samartzis D, Hu R, Barz T, Stuber K, Schneider M, Haig A, Schizas C, Cheung J, Mannion AF, Staub L, Comer C, Macedo L, Ahn SH, Takahashi K, Sandella D, Battie M (2016) Consensus on the clinical diagnosis of lumbar spinal stenosis: results of an International Delphi Study. Spine.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Genevay S, Courvoisier DS, Konstantinou K, Kovacs FM, Marty M, Rainville J, Norberg M, Kaux JF, Cha TD, Katz JN, Atlas SJ (2018) Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria. Spine J 18(6):941–947.

    Article  PubMed  Google Scholar 

  5. 5.

    Malfair D, Beall DP (2007) Imaging the degenerative diseases of the lumbar spine. Magn Reson Imaging Clin N Am 15(2):221-238,vi.

    Article  Google Scholar 

  6. 6.

    Andreisek G, Imhof M, Wertli M, Winklhofer S, Pfirrmann CW, Hodler J, Steurer J, Lumbar Spinal Stenosis Outcome Study Working Group Zurich (2013) A systematic review of semiquantitative and qualitative radiologic criteria for the diagnosis of lumbar spinal stenosis. AJR Am J Roentgenol 201(5):W735–W746.

    Article  PubMed  Google Scholar 

  7. 7.

    Mamisch N, Brumann M, Hodler J, Held U, Brunner F, Steurer J, Lumbar Spinal Stenosis Outcome Study Working Group Zurich (2012) Radiologic criteria for the diagnosis of spinal stenosis: results of a Delphi survey. Radiology 264(1):174–179.

    Article  PubMed  Google Scholar 

  8. 8.

    Andreisek G, Deyo RA, Jarvik JG, Porchet F, Winklhofer SF, Steurer J, LSOS Working Group (2014) Consensus conference on core radiological parameters to describe lumbar stenosis—an initiative for structured reporting. Eur Radiol 24(12):3224–3232.

    Article  PubMed  Google Scholar 

  9. 9.

    Kim YU, Kong YG, Lee J, Cheong Y, Kim S, Kim HK, Park JY, Suh JH (2015) Clinical symptoms of lumbar spinal stenosis associated with morphological parameters on magnetic resonance images. Eur Spine J 24(10):2236–2243.

    Article  PubMed  Google Scholar 

  10. 10.

    Yabuki S, Fukumori N, Takegami M, Onishi Y, Otani K, Sekiguchi M, Wakita T, Kikuchi S, Fukuhara S, Konno S (2013) Prevalence of lumbar spinal stenosis, using the diagnostic support tool, and correlated factors in Japan: a population-based study. J Orthop Sci 18(6):893–900.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Ishimoto Y, Yoshimura N, Muraki S, Yamada H, Nagata K, Hashizume H, Takiguchi N, Minamide A, Oka H, Kawaguchi H, Nakamura K, Akune T, Yoshida M (2012) Prevalence of symptomatic lumbar spinal stenosis and its association with physical performance in a population-based cohort in Japan: the Wakayama Spine Study. Osteoarthritis Cartilage 20(10):1103–1108.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Otani K, Kikuchi S, Yabuki S, Igarashi T, Nikaido T, Watanabe K, Konno S (2013) Lumbar spinal stenosis has a negative impact on quality of life compared with other comorbidities: an epidemiological cross-sectional study of 1862 community-dwelling individuals. ScientificWorldJournal 2013:590652.

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Kalichman L, Cole R, Kim DH, Li L, Suri P, Guermazi A, Hunter DJ (2009) Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine J 9(7):545–550.

    Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Chiba D, Tsuda E, Wada K, Kumagai G, Sasaki E, Nawata A, Nakagomi S, Takahashi I, Nakaji S, Ishibashi Y (2016) Lumbar spondylosis, lumbar spinal stenosis, knee pain, back muscle strength are associated with the locomotive syndrome: rural population study in Japan. J Orthop Sci 21(3):366–372.

    Article  PubMed  Google Scholar 

  15. 15.

    Sugioka T, Hayashino Y, Konno S, Kikuchi S, Fukuhara S (2008) Predictive value of self-reported patient information for the identification of lumbar spinal stenosis. Fam Pract 25(4):237–244.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Booth A, Clarke M, Dooley G, Ghersi D, Moher D, Petticrew M, Stewart L (2013) PROSPERO at one year: an evaluation of its utility. Syst Rev 2:4.

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Jensen RK, Jensen TS, Koes B, Hartvigsen J (2018) Systematic review and meta-analysis of the prevalence of lumbar spinal stenosis in the general population, and in primary and secondary care. PROSPERO 2018 CRD42018109640. Accessed 27 Jan 2020

  18. 18.

    Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283(15):2008–2012.

    CAS  Article  Google Scholar 

  19. 19.

    Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, Baker P, Smith E, Buchbinder R (2012) Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 65(9):934–939.

    Article  PubMed  Google Scholar 

  21. 21.

    Ishimoto Y, Yoshimura N, Muraki S, Yamada H, Nagata K, Hashizume H, Takiguchi N, Minamide A, Oka H, Kawaguchi H, Nakamura K, Akune T, Yoshida M (2013) Associations between radiographic lumbar spinal stenosis and clinical symptoms in the general population: the Wakayama Spine Study. Osteoarthritis Cartilage 21(6):783–788.

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Weiner DK, Sakamoto S, Perera S, Breuer P (2006) Chronic low back pain in older adults: prevalence, reliability, and validity of physical examination findings. J Am Geriatr Soc 54(1):11–20.

    Article  PubMed  PubMed Central  Google Scholar 

  23. 23.

    Beaudet N, Courteau J, Sarret P, Vanasse A (2013) Prevalence of claims-based recurrent low back pain in a Canadian population: a secondary analysis of an administrative database. BMC Musculoskelet Disord 14:151.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Dobbs R, May S, Hope P (2016) The validity of a clinical test for the diagnosis of lumbar spinal stenosis. Man Ther 25:27–34.

    Article  PubMed  Google Scholar 

  25. 25.

    Ahn YJ, Shin JS, Lee J, Lee YJ, Kim MR, Park KB, Lee JH, Shin KM, Ha IH (2016) Evaluation of use and cost of medical care of common lumbar disorders in Korea: cross-sectional study of Korean Health Insurance Review and Assessment Service National Patient Sample data. BMJ Open 6(9):e012432.

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Orita S, Yamashita T, Ohtori S, Yonenobu K, Kawakami M, Taguchi T, Kikuchi SI, Ushida T, Konno SI, Nakamura M, Fujino K, Matsuda S, Yone K, Takahashi K (2016) Prevalence and location of neuropathic pain in lumbar spinal disorders. Spine 41(15):1224–1231.

    Article  PubMed  Google Scholar 

  27. 27.

    Mijiyawa M, Oniankitan O, Kolani B, Koriko T (2000) Low back pain in hospital outpatients in Lome (Togo). Joint Bone Spine 67(6):533–538

    CAS  Article  Google Scholar 

  28. 28.

    Pahl MA, Brislin B, Boden S, Hilibrand AS, Vaccaro A, Hanscom B, Albert TJ (2006) The impact of four common lumbar spine diagnoses upon overall health status. Spine J 6(2):125–130.

    Article  PubMed  Google Scholar 

  29. 29.

    Katz JN, Dalgas M, Stucki G, Katz NP, Bayley J, Fossel AH, Chang LC, Lipson SJ (1995) Degenerative lumbar spinal stenosis. Diagnostic value of the history and physical examination. Arthritis Rheum 38(9):1236–1241

    CAS  Article  Google Scholar 

  30. 30.

    Boakye M, Moore R, Kong M, Skirboll SL, Arrigo RT (2013) Health-related quality-of-life status in Veterans with spinal disorders. Qual Life Res 22(1):45–52.

    Article  PubMed  Google Scholar 

  31. 31.

    Laslett M, McDonald B, Tropp H, Aprill CN, Oberg B (2005) Agreement between diagnoses reached by clinical examination and available reference standards: a prospective study of 216 patients with lumbopelvic pain. BMC Musculoskelet Disord 6:28.

    Article  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Tsutsumimoto T, Shimogata M, Yui M, Ohta H, Misawa H (2012) The natural history of asymptomatic lumbar canal stenosis in patients undergoing surgery for cervical myelopathy. J Bone Joint Surg Br 94(3):378–384.

    CAS  Article  PubMed  Google Scholar 

  33. 33.

    Sekiguchi M, Yonemoto K, Kakuma T, Nikaido T, Watanabe K, Kato K, Otani K, Yabuki S, Kikuchi S, Konno S (2015) Relationship between lumbar spinal stenosis and psychosocial factors: a multicenter cross-sectional study (DISTO project). Eur Spine J 24(10):2288–2294.

    Article  PubMed  Google Scholar 

  34. 34.

    Konno S, Hayashino Y, Fukuhara S, Kikuchi S, Kaneda K, Seichi A, Chiba K, Satomi K, Nagata K, Kawai S (2007) Development of a clinical diagnosis support tool to identify patients with lumbar spinal stenosis. Eur Spine J 16(11):1951–1957.

    Article  PubMed  PubMed Central  Google Scholar 

  35. 35.

    Al-Saeed O, Al-Jarallah K, Raeess M, Sheikh M, Ismail M, Athyal R (2012) Magnetic resonance imaging of the lumbar spine in young arabs with low back pain. Asian Spine J 6(4):249–256.

    Article  PubMed  PubMed Central  Google Scholar 

  36. 36.

    Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW (1990) Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72(3):403–408

    CAS  Article  Google Scholar 

  37. 37.

    Parkkola R, Rytokoski U, Kormano M (1993) Magnetic resonance imaging of the discs and trunk muscles in patients with chronic low back pain and healthy control subjects. Spine (Phila Pa 1976) 18(7):830–836

    CAS  Article  Google Scholar 

  38. 38.

    Jarvik JJ, Hollingworth W, Heagerty P, Haynor DR, Deyo RA (2001) The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study: baseline data. Spine (Phila Pa 1976) 26(10):1158–1166

    CAS  Article  Google Scholar 

  39. 39.

    Carragee E, Alamin T, Cheng I, Franklin T, van den Haak E, Hurwitz E (2006) Are first-time episodes of serious LBP associated with new MRI findings? Spine J 6(6):624–635.

    Article  PubMed  Google Scholar 

  40. 40.

    Chiodo A, Haig AJ, Yamakawa KS, Quint D, Tong H, Choksi VR (2007) Needle EMG has a lower false positive rate than MRI in asymptomatic older adults being evaluated for lumbar spinal stenosis. Clin Neurophysiol 118(4):751–756.

    Article  PubMed  Google Scholar 

  41. 41.

    Matsumoto M, Okada E, Toyama Y, Fujiwara H, Momoshima S, Takahata T (2013) Tandem age-related lumbar and cervical intervertebral disc changes in asymptomatic subjects. Eur Spine J 22(4):708–713.

    Article  PubMed  Google Scholar 

  42. 42.

    Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine (Phila Pa 1976) 30(10):1173–1180

    Article  Google Scholar 

  43. 43.

    de Schepper EI, Koes BW, Veldhuizen EF, Oei EH, Bierma-Zeinstra SM, Luijsterburg PA (2016) Prevalence of spinal pathology in patients presenting for lumbar MRI as referred from general practice. Fam Pract 33(1):51–56.

    Article  PubMed  Google Scholar 

  44. 44.

    Baykara RA, Bozgeyik Z, Akgul O, Ozgocmen S (2013) Low back pain in patients with rheumatoid arthritis: clinical characteristics and impact of low back pain on functional ability and health related quality of life. J Back Musculoskelet Rehabil 26(4):367–374.

    Article  PubMed  Google Scholar 

  45. 45.

    Albert HB, Briggs AM, Kent P, Byrhagen A, Hansen C, Kjaergaard K (2011) The prevalence of MRI-defined spinal pathoanatomies and their association with Modic changes in individuals seeking care for low back pain. Eur Spine J 20(8):1355–1362

    Article  Google Scholar 

  46. 46.

    Cheng F, You J, Rampersaud YR (2010) Relationship between spinal magnetic resonance imaging findings and candidacy for spinal surgery. Can Fam Physician 56(9):E323–E330

    PubMed  PubMed Central  Google Scholar 

  47. 47.

    de Bruin F, Treyvaud MO, Feydy A, de Hooge M, Pialat JB, Dougados M, Gossec L, Bloem JL, van der Heijde D, Reijnierse M (2018) Prevalence of degenerative changes and overlap with spondyloarthritis-associated lesions in the spine of patients from the DESIR cohort. RMD Open 4(1):e000657.

    Article  PubMed  PubMed Central  Google Scholar 

  48. 48.

    Mariconda M, Lotti G, Fava R, Midolo R, Longo C, Milano C (2004) Quantitative ultrasound measurements of the calcaneus in the prediction of lumbar spine degeneration. Eur Spine J 13(4):346–353.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Fu KM, Rhagavan P, Shaffrey CI, Chernavvsky DR, Smith JS (2011) Prevalence, severity, and impact of foraminal and canal stenosis among adults with degenerative scoliosis. Neurosurgery 69(6):1181–1187.

    Article  PubMed  Google Scholar 

  50. 50.

    Modic MT, Obuchowski NA, Ross JS, Brant-Zawadzki MN, Grooff PN, Mazanec DJ, Benzel EC (2005) Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome. Radiology 237(2):597–604

    Article  Google Scholar 

  51. 51.

    Ullah W, Ali M, Khan Z (2018) Frequency of incidental durotomy during surgery for degenerative lumbar spine disease: an experience in neurosurgery department of a tertiary care hospital. J Postgrad Med Inst 32(1):99–102

    Google Scholar 

  52. 52.

    Kalichman L, Guermazi A, Li L, Hunter DJ (2009) Association between age, sex, BMI and CT-evaluated spinal degeneration features. J Back Musculoskelet Rehabil 22(4):189–195.

    Article  PubMed  Google Scholar 

  53. 53.

    Kuboyama I, Toyokawa S, Tomio J, Inada H, Tanihara S, Kobayashi Y (2016) The Number of Patients and Therapeutic Profile of Spinal Stenosis Using Health Insurance Claims in Japan. Spine (Phila Pa 1976) 41(14):1146–1152.

    Article  Google Scholar 

  54. 54.

    Yamada K, Satoh S, Hashizume H, Yoshimura N, Kagotani R, Ishimoto Y,  Abe Y, Toyoda H, Terai H, Masuda T, Muraki S, Nakamura H, Yoshida M (2019) Diffuse idiopathic skeletal hyperostosis is associated with lumbar spinal stenosis requiring surgery. J Bone Miner Metabol 37(1):118–124

    Article  Google Scholar 

  55. 55.

    Ishimoto Y, Yoshimura N, Muraki S, Yamada H, Nagata K, Hashizume H, Takiguchi N, Minamide A, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T, Yoshida M (2017) Association of lumbar spondylolisthesis with low back pain and symptomatic lumbar spinal stenosis in a population-based cohort: the Wakayama Spine Study. Spine (Phila Pa 1976) 42(11):E666–E671.

    Article  Google Scholar 

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Correspondence to Rikke Krüger Jensen.

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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).

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