Purpose

To systematically evaluate any consensus for the etiology, definition, presentation and outcomes of developmental lumbar spinal stenosis (DLSS).

Methods

A comprehensive literature search was undertaken by 2 independent reviewers with PubMed, Ovid, and Web of Science to identify all published knowledge on DLSS. Search terms included “developmental spinal stenosis” or “congenital spinal stenosis” and “lumbar”. The inclusion criteria were English clinical studies with sample size larger than 8, articles examining the etiology, diagnostic criteria, surgical outcomes of DLSS, and its association with other spinal pathologies. Articles that did not specify a developmental component were excluded. The GRADE approach was used to assess their quality of evidence.

Results

The initial database review found 404 articles. Twenty articles with moderate to very low quality met the inclusion criteria for analysis. The bony canal diameter was significantly shorter in patients with DLSS than normal subjects. In addition, the risk of re-operation on adjacent levels (21.7%) was high which could be explained by multi-level stenosis. However, there was a lack of consensus on the methodology of diagnosing DLSS and on its specific surgical techniques.

Conclusion

Multi-level stenosis and re-operation at adjacent levels are especially common with DLSS. Identification of these individuals provides better prognostication after surgery. However, current literature provides few consensus on its definition and the required surgical approach. Besides, there are limited reports of its etiology and association with other spinal pathologies. Due to these limitations, standardizing the definition of DLSS and investigating its etiology and expected clinical course are necessary.

中文翻译：

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发育性腰椎管狭窄症的系统评价。

目的

为了系统地评估发育性腰椎管狭窄症（DLSS）的病因，定义，表现和结果的任何共识。

方法

由2位独立评论者与PubMed，Ovid和Web of Science进行了全面的文献搜索，以识别所有关于DLSS的公开知识。搜索词包括“发育性脊椎狭窄”或“先天性脊椎狭窄”和“腰部”。纳入标准为英国临床研究，样本量大于8，检查了DLSS的病因，诊断标准，手术结局及其与其他脊柱病理的关系。未指定发展要素的文章被排除在外。GRADE方法用于评估其证据质量。

结果

最初的数据库审查发现404篇文章。20篇质量中等至极低的文章均符合纳入标准。DLSS患者的骨管直径明显短于正常受试者。此外，在相邻级别再次手术的风险较高（21.7％），这可以通过多级狭窄来解释。但是，在诊断DLSS的方法及其特定的手术技术上缺乏共识。

结论

多级狭窄和相邻级的再手术在DLSS中尤为常见。鉴定这些个体可在手术后提供更好的预后。但是，目前的文献对其定义和所需的手术方法尚无共识。此外，关于其病因学以及与其他脊柱病理学的关系的报道很少。由于这些限制，有必要标准化DLSS的定义并研究其病因和预期的临床过程。