Md. Iverson et Jn. Katz, Examination findings and self-reported walking capacity in patients with lumbar spinal stenosis, PHYS THER, 81(7), 2001, pp. 1296-1306
Background and Purpose. Spinal stenosis is a common, often disabling, condi
tion resulting from compression of tile cauda equina and nerve roots. This
study was designed to: (1) characterize tile impairments of patients with l
umbar spinal stenosis (LSS) and (2) to identify predictors of self-reported
walking capacity. Subjects. Forty-three patients with symptomatic LSS, fro
m 3 specialty clinics, were evaluated. Twenty-eight subjects (65%) were fem
ale. The subjects' median age was 73.6 years ((X) over bar =72.4, SD=10.3,
range=45.7-90.7), and the median duration of low back pain was 24 months ((
X) over bar =36.6, SD=41.6, range=0-216). Methods. Demographic data, medica
l history, and information about low back pain and symptoms (eg, numbness,
tingling, and lower-extremity weakness) were collected using a standardized
questionnaire and physical examination. Results. Twenty-two subjects (51%)
had lower-extremity weakness, primarily of the extensor hallucis longus mu
scle. Thirty-five subjects (81%) had absent or decreased neurosensory respo
nses (eg, pinprick, vibration, reflexes), and 28 subjects (66%) reported th
at they were unable to walk farther than 2 blocks. Women were more likely t
han men to report difficulties walking, as were subjects with abnormal Romb
erg test scores and those with greater pain during walking. Discussion and
Conclusion. Pain and balance problems appeared to be the primary factors li
miting ambulation in our subjects with LSS.