Test library › Low back & pelvis
Clinical tests for lumbar spinal stenosis, compared
Narrowing of the spaces in the lower spine that carry the nerves, usually from age-related change. Typically causes pain, heaviness or tingling in the buttocks or legs on walking or standing that eases with sitting or bending forward.
The 4 tests in the library for lumbar spinal stenosis, side by side, each with the published accuracy figures that exist for it. Click a test for what each result means, any caution, and the source.
| Test | Sensitivity | Specificity | LR+ | LR− | Verdict |
|---|---|---|---|---|---|
| Lumbar spinal stenosis diagnostic support tool (Konno score) (website only) | 92.8% | 72% | 3.3 | 0.1 | Treat with caution |
| Lumbar spinal stenosis history cluster (Cook, 5 items) (website only) | 96% | not given | not given | 0.19 | Treat with caution |
| No pain when seated (lumbar spinal stenosis) (website only) | 47% | 94% | 7.4 | 0.57 | Treat with caution |
| Wide-based gait (lumbar spinal stenosis) (website only) | 42% | 97% | 13 | 0.6 | Treat with caution |
Reading the table
A high LR+ makes a positive result useful for ruling the condition in; a low LR− makes a negative result useful for ruling it out. A test can be good in one direction and weak in the other, and the figures come from different studies and patient groups, so compare them with care.
Tests for the same problem are rarely independent, so a second positive adds much less than its own figure suggests. Do not multiply their figures together. Where a combination has been tested as a cluster or a decision rule, its published result is given on that cluster’s own page.
To turn a figure into a probability for your patient, use the probability calculator.
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None of these tests has a separate test card in Rule It In, Rule It Out. The book’s ‘The low back and pelvis’ chapter discusses this condition and gives the published figures for the history and examination findings it relies on.
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