Systematic review of diagnostic accuracy of patient history, clinical findings, and physical tests in the diagnosis of lumbar spinal stenosis

Review written by Dr Mary O'Keeffe info

Key Points

  1. Evidence of our ability to accurately rule in and rule out lumbar spinal stenosis in the clinic is of great interest to clinicians dealing with people with low back pain (LBP).
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A systematic review published this year in the European Spine Journal tackled an important question about our ability to rule in or rule out a diagnosis of lumbar spinal stenosis. The review by Cook and colleagues is very relevant to physiotherapists as in the absence of a gold standard test for diagnosing lumbar spinal stenosis; we must depend on our clinical assessment to attempt to rule in and rule out a diagnosis of lumbar spinal stenosis. So, can patient demographics, patient history, clinical assessment findings, and physical tests aid clinicians in the ruling in or ruling out of lumbar spinal stenosis? That is what this systematic review sought to find out.

There is no one gold standard test for diagnosing lumbar spinal stenosis.
While clinicians should acknowledge the limitations of this research, it is worth considering these components in your patient assessment to help rule in or out lumbar stenosis.


The authors conducted a systematic review of diagnostic accuracy studies for lumbar spinal stenosis. They searched three electronic databases from inception to November 2018 to locate potentially relevant studies. There were no language restrictions.

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