Clinical assessment and management of lumbar spinal stenosis: clinical dilemmas and considerations for surgical referral

被引：3
|
作者：
Anderson, David B. [1 ,2 ]
Beard, David J. [3 ]
Rannou, Francois [4 ,5 ,6 ]
Hunter, David J. [7 ,8 ]
Suri, Pradeep [9 ,10 ]
Chen, Lingxiao [11 ]
Van Gelder, James M. [12 ,13 ]
机构：
[1] Univ Sydney, Fac Med & Hlth, Sch Hlth Sci, Sydney, NSW 2050, Australia
[2] Univ Sydney, Fac Med & Hlth, Sydney Musculoskeletal Hlth, Patyegarang Precinct, Sydney, NSW, Australia
[3] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Div Med Sci, Oxford, England
[4] Hop Cochin, AP HP Ctr, Dept Phys & Rehabil Med, Paris, France
[5] Univ Paris Cite, Fac Sante, UFR Med, Paris, France
[6] INSERM, UMR S 1124, Paris, France
[7] Univ Sydney, Kolling Inst, Fac Med & Hlth, Sydney Musculoskeletal Hlth,Arabanoo Precinct, Sydney, NSW, Australia
[8] Royal North Shore Hosp, Dept Rheumatol, Sydney, NSW, Australia
[9] VA Puget Sound Hlth Care Syst, Div Rehabil Care Serv, Seattle, WA USA
[10] Univ Washington, Dept Rehabil Med, Seattle, WA USA
[11] Shandong Univ, Adv Med Res Inst, Cheeloo Coll Med, Ctr Orthopaed,Dept Orthopaed,Qilu Hosp, Jinan, Shandong, Peoples R China
[12] Concord Repatriat Gen Hosp, Neurosurg Dept, Sydney, NSW, Australia
[13] Univ New South Wales, Univ New South Wales Med & Hlth, Sch Clin Med, Sydney, NSW, Australia
来源：
LANCET RHEUMATOLOGY | 2024年 / 6卷 / 10期
关键词：
DIAGNOSIS; GUIDELINE; SURGERY; PAIN;
D O I：
10.1016/S2665-9913(24)00028-6
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Lumbar spinal stenosis is the leading indication for spine surgery in older adults. Surgery is recommended in clinical guidelines if non-surgical treatments have been provided with insufficient benefit. The difficulty for clinicians is that the current number of randomised controlled trials is low, which creates uncertainty about which treatments to provide. For non-surgical clinicians this paucity of data leads to a clinical dilemma of whether to continue managing the patient or refer to a spine surgeon. This Viewpoint aims to provide an update on the assessment of lumbar spinal stenosis, treatment recommendations, indications for referral to a spine surgeon, and current clinical dilemmas facing non-surgical clinicians and spinal surgeons.
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收藏
页数：6
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