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Wide-based gait (lumbar spinal stenosis)

For: Lumbar spinal stenosis

Website-only page: no separate test card in the book, which discusses this in its ‘The low back and pelvis’ chapter.

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.

Treat with caution (see below)
Sensitivity42%
Specificity97%
LR+ (positive)13
LR− (negative)0.6

Likelihood ratios as published by the review.

Caution: Single small study (93 patients) in specialty clinics; the 95% confidence interval for LR+ is wide (1.9 to 95).

How it is done

Watch the patient walk. Positive: they walk with a wide base of support (feet further apart than normal).

What the studies found

Clinical syndrome of lumbar spinal stenosis. From a single study (Katz 1995: 93 patients in 3 specialty clinics, 46% with stenosis), reported in the Suri 2010 JAMA review, which rated it at the lowest evidence level of the studies included. Sensitivity 42% (95% CI 27–57%), specificity 97% (91–100%), LR+ 13 (1.9–95), LR− 0.60 (0.46–0.78). The very wide LR+ interval means the true value could be modest. The reference standard was the diagnosis of expert spine clinicians supported by MRI or CT, so partly clinical opinion. Most people with stenosis do not have a wide-based gait, so a normal gait does not rule it out. A wide-based gait also occurs with cervical myelopathy and with cerebellar or vestibular (balance) problems.

What the numbers mean

  • Positive result: see the caution above before relying on this result.
  • Negative result: barely informative: a negative result changes little.

The ladder: what a result does to your estimate

If you thoughtAfter a positiveAfter a negative
10%59%6%
30%85%20%
50%93%38%

Calculated from the likelihood ratios above. Read the caution above before relying on these. For any other starting estimate, use the probability calculator.

Work out what a result means for your patient: probability calculator

Other tests in the library for lumbar spinal stenosis

Compare all the tests for lumbar spinal stenosis side by side

Source

Suri P, Rainville J, Kalichman L, Katz JN. Does this older adult with lower extremity pain have the clinical syndrome of lumbar spinal stenosis? JAMA. 2010;304(23):2628–2636. Journal article (DOI) · systematic review
Also cited: Katz JN, Dalgas M, Stucki G, et al. Degenerative lumbar spinal stenosis: diagnostic value of the history and physical examination. Arthritis Rheum. 1995;38(9):1236–1241. Journal article (DOI)

Website-only page, added to the library on 9 October 2026. Rule It In, Rule It Out discusses this but has no separate test card for it. Figures independently checked against the sources cited above; any note above says where only the abstract could be checked.

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