Skip to main content
SpringerLink
Log in

Awareness and use of diagnostic support tools for lumbar spinal stenosis in Japan

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Lumbar spinal stenosis (LSS) is a major clinical problem associated with back pain, intermittent claudication, leg pain, and leg numbness. Diagnostic support tools for LSS such as the self-administered, self-reported history questionnaire (SSHQ) and developmental clinical diagnosis support tool (ST) have been validated in Japan. However, the degree of awareness and use of these two diagnostic support tools for LSS in Japan has not been clarified. The aims of the current study were to determine the degree of awareness and use of these two diagnostic support tools by Japanese physicians. Furthermore, we compared these results among nonorthopedic general practitioner (GP), orthopedic GP, and hospital-based orthopedic physicians.

Methods

The LSS Diagnosis Support Tool (DISTO) Project was conducted to evaluate the degree of awareness and use of these two diagnostic support tools in Japan from 2011 to 2012. A total of 1,811 answers were obtained from physicians including nonorthopedic general practitioners (GP), orthopedic GPs, and hospital-based orthopedic physicians. Questions were (1) Do you know about these two diagnostic tools? and (2) If you know about these two diagnostic tools, have you used them?

Results

The degree of awareness of ST and SSHQ was about 30 and 26 % by nonorthopedic GPs, 70 and 46 % by orthopedic GPs, and 68 and 41 % by hospital-based orthopedic physicians. The degree of awareness of ST and SSHQ by nonorthopedic GPs was significantly lower than by orthopedic GPs or hospital-based orthopedic physicians (p < 0.001). For physicians who were aware of ST and SSHQ, the degree of use of ST or SSHQ was <50 % by nonorthopedic GPs, orthopedic GPs, and hospital-based orthopedic physicians.

Conclusions

We expect that use of the ST or SSHQ tools in primary care will improve the accuracy of diagnosis and lead to improved quality of patient care. The low proportion of awareness by nonorthopedic GPs (<30 %) and use by all physicians (<50 %) indicate a need to encourage physicians to use ST and SSHQ more frequently.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Konno S, Yabuki S, Sato K, Kikuchi S. A model for acute, chronic, and delayed graded compression of the dog cauda equina: presentation of the gross, microscopic, and vascular anatomy of the dog cauda equina and accuracy in pressure transmission of the compression model. Spine. 1995;20:2758–64.

    Article  CAS  PubMed  Google Scholar 

  2. Sekiguchi M, Kikuchi S, Myers RR. Experimental spinal stenosis: relationship between degree of cauda equina compression, neuropathology, and pain. Spine. 2004;29:1105–11.

    Article  PubMed  Google Scholar 

  3. Gunzburg R, Keller TS, Szpalski M, Vandeputte K, Spratt KF. A prospective study on CT scan outcomes after conservative decompression surgery for lumbar spinal stenosis. J Spinal Disord Tech. 2003;16:261–7.

    Article  CAS  PubMed  Google Scholar 

  4. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects: a prospective investigation. J Bone Joint Surg Am. 1990;72:403–8.

    CAS  PubMed  Google Scholar 

  5. Joaquim AF, Sansur CA, Hamilton DK, Shaffrey CI. Degenerative lumbar stenosis: update. Arq Neuropsiquiatr. 2009;67(2B):553–8.

    Article  PubMed  Google Scholar 

  6. Kreiner DS, Shaffer WO, Baisden JL, Gilbert TJ, Summers JT, Toton JF, Hwang SW, Mendel RC, Reitman CA. An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update). Spine J. 2013;13:734–43.

    Article  PubMed  Google Scholar 

  7. Konno S, Kikuchi S, Tanaka Y, Yamazaki K, Shimada Y, Takei H, Yokoyama T, Okada M, Kokubun S. A diagnostic support tool for lumbar spinal stenosis: a self-administered, self-reported history questionnaire. BMC Musculoskelet Disord. 2007;8:102.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Konno S, Hayashino Y, Fukuhara S, Kikuchi S, Kaneda K, Seichi A, Chiba K, Satomi K, Nagata K, Kawai S. Development of a clinical diagnosis support tool to identify patients with lumbar spinal stenosis. Eur Spine J. 2007;16:1951–7.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Sugioka T, Hayashino Y, Konno S, Kikuchi S, Fukuhara S. Predictive value of selfreported patient information for the identification of lumbar spinal stenosis. Fam Pract. 2008;25:237–44.

    Article  PubMed  Google Scholar 

  10. Katz JN, Dalgas M, Stucki G, Katz NP, Bayley J, Fossel AH, Chang LC, Lipson SJ. Degenerative lumbar spinal stenosis. Diagnostic value of the history and physical examination. Arthritis Rheum. 1995;38:1236–41.

    Article  CAS  PubMed  Google Scholar 

  11. de Graaf I, Prak A, Bierma-Zeinstra S, Thomas S, Peul W, Koes P. Diagnosis of lumbar spine stenosis. Spine. 2006;31:1168–76.

    Article  PubMed  Google Scholar 

  12. Katz JN, Harris MB. Lumbar spinal stenosis. N Engl J Med. 2008;358:818–25.

    Article  CAS  PubMed  Google Scholar 

  13. Lin SI, Lin RM. Disability and walking capacity in patients with lumbar spinal stenosis: association with sensorimotor function, balance, and functional performance. J Orthop Sports Phys Ther. 2005;35:220–6.

    Article  PubMed  Google Scholar 

  14. Haig AJ, Tong HC, Yamakawa KS, Parres C, Quint DJ, Chiodo A, Miner JA, Phalke VC, Hoff JT, Geisser ME. Predictors of pain and function in persons with spinal stenosis, low back pain, and no back pain. Spine. 2006;31:2950–7.

    Article  PubMed  Google Scholar 

  15. Amundsen T, Weber H, Nordal HJ, Magnaes B, Abdelnoor M, Lilleâs F. Lumbar spinal stenosis: conservative or surgical management?: a prospective 10-year study. Spine. 2000;25:1424–6.

    Article  CAS  PubMed  Google Scholar 

  16. Miyamoto H, Sumi M, Uno K, Tadokoro K, Mizuno K. Clinical outcome of nonoperative treatment for lumbar spinal stenosis, and predictive factors relating to prognosis, in a 5-year minimum follow-up. J Spinal Disord Tech. 2008;21:563–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors have no one to acknowledge. The authors received financial funding for data collection, analysis, or writing of the manuscript from the Japanese Society for Spine Surgery and Related Research.

Conflict of interest

The authors did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Seiji Ohtori & Kazuhisa Takahashi

  2. Department of Orthopedic Surgery, School of Medicine, Fukushima Medical University, Fukushima, Japan

    Miho Sekiguchi & Shinichi Konno

  3. Biostatistics Center, Kurume University, Fukuoka, Japan

    Koji Yonemoto & Tatsuyuki Kakuma

Authors
  1. Seiji Ohtori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miho Sekiguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Koji Yonemoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tatsuyuki Kakuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kazuhisa Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shinichi Konno
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seiji Ohtori.

Additional information

For the DISTO-project group. Members of the research groups are listed in the Appendix.

Appendix

Appendix

Lumbar Spinal Stenosis Diagnosis Support Tool (DISOTO)-project group.

Chairman: Shin-ichi Kikuchi (Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine).

Research members: Shin-ichi Kikuchi, Shin-ichi Konno, Miho Sekiguchi (Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine), Kazuhisa Takahashi, Seiji Ohtori (Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University), Tatsuyuki Kakuma, Koji Yonemoto (Department of Bio-statistics, Kurume University School of Medicine), Kazuo Yonenobu (Department of Orthopaedic Surgery, Osaka Minami Medical Center), Keisuke Takahashi, Hideki Iizuka (Department of Orthopaedic Surgery, Saitama Medical University, Faculte of Medicine), Toshihiko Taguchi, Tukasa Kanchiku (Department of Orthopaedic Surgery Yamguchi University Faculty of Medicine and Health Sciences), Katsushi Takeshita, Nobuhiro Hara (Department of Orthopaedic Surgery, The University of Tokyo Faculty of Medicine), Toshikazu Tani, Ryuichi Takemasa (Department of Orthopaedic Surgery, Kochi Medical School), Kazuhiro Chiba (Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital), Naofumi Hozogane (Department of Orthopaedic Surgery, Keio University School of Medicein), Kensei Nagata, Kimiaki Sato (Department of Orthopaedic Surgery, Kurume University School of Medicien), Yutaka Nohara, Hiroshi Teneichi (Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine), Yuichi Hoshino, Atsushi Seichi (Department of Orthopaedic Surgery, Jichi Medicau University), Toshihiko Yamashita, Tsuneo Takebayashi (Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine), Munehito Yoshida, Hiroshi Yamada (Department of Orthopaedic Surgery, Wakayama Medical University).

Research Associate members: Takuya Nikaido, Kazuyuki Watanabe, Kinshi Kato (Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine).

About this article

Cite this article

Ohtori, S., Sekiguchi, M., Yonemoto, K. et al. Awareness and use of diagnostic support tools for lumbar spinal stenosis in Japan. J Orthop Sci 19, 412–417 (2014). https://doi.org/10.1007/s00776-014-0551-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00776-014-0551-1

Keywords

Search

Navigation