Examination findings and self-reported walking capacity in patients with lumbar spinal stenosis.
OBJECTIVE
Spinal stenosis is a common, often disabling, condition resulting from compression of the cauda equina and nerve roots. This study was designed to: (1) characterize the impairments of patients with lumbar spinal stenosis (LSS) and (2) to identify predictors of self-reported walking capacity.


METHODS
Forty-three patients with symptomatic LSS, from 3 specialty clinics, were evaluated. Twenty-eight subjects (65%) were female. The subjects' median age was 73.6 years (mean=72.4, SD=10.3, range=45.7-90.7), and the median duration of low back pain was 24 months (mean=36.6, SD=41.6, range=0-216).


METHODS
Demographic data, medical 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 muscle. Thirty-five subjects (81%) had absent or decreased neurosensory responses (eg, pinprick, vibration, reflexes), and 28 subjects (66%) reported that they were unable to walk farther than 2 blocks. Women were more likely than men to report difficulties walking, as were subjects with abnormal Romberg test scores and those with greater pain during walking.


CONCLUSIONS
Pain and balance problems appeared to be the primary factors limiting ambulation in our subjects with LSS.
Iversen
M D
MD
Department of Physical Therapy, Graduate School for Health Sciences, Simmons College, 300 The Fenway, Boston, MA 02115, USA. iversen@simmons.edu
Katz
J N
JN
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D010808:Physical Examination / Q000379:methods*; D004856:Postural Balance; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013130:Spinal Stenosis / Q000175:diagnosis / Q000503:physiopathology*; D016138:Walking