965. Lumbar spinal stenosis

Lumbar spinal stenosis จะมีแนวทางในการตรวจวินิจฉัยโดยใช้อาการทางคลินิก(clinical diagnosis) อย่างไร

ภาพจาก http://www.lowerbackpain-cause.com/files/2010/12/spinalstenosis.jpg

Accuracy of Individual Signs and Symptoms in the Diagnosis of Lumbar Spinal Stenosis

Clinical Decision Rule for the Diagnosis of Lumbar Spinal Stenosis

Findings		Points

Age < 60 years      0

60 to 70 years            2

> 70 years             3
Onset of symptoms occurred more than six months ago 1
Symptoms improve when bending forward     2
Symptoms improve when bending backward   –2
Symptoms worsen when standing up     2
Intermittent claudication present    1
Urinary incontinence present    1

Score    Probability of lumbar spinal stenosis
≤ 2        11/66 (16.7%)
3 or 4    35/120 (29.2%)
5 or 6    78/151 (51.7%)
≥ 7        98/131 (74.8%)

Ref: http://www.aafp.org/afp/2009/1115/p1145.html