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Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis

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Abstract

Purpose

To estimate the prevalence of degenerative lumbar spinal stenosis (LSS) in adults, identified by clinical symptoms and/or radiological criteria.

Methods

Systematic review of the literature. Pooled prevalence estimates by care setting and clinical or radiological diagnostic criteria were calculated and plotted [PROSPERO ID: CRD42018109640].

Results

In total, 41 papers reporting on 55 study samples were included. The overall risk of bias was considered high in two-thirds of the papers. The mean prevalence, based on a clinical diagnosis of LSS in the general population, was 11% (95% CI 4–18%), 25% (95% CI 19–32%) in patients from primary care, 29% (95% CI 22–36%) in patients from secondary care and 39% (95% CI 39–39%) in patients from mixed primary and secondary care. Evaluating the presence of LSS based on radiological diagnosis, the pooled prevalence was 11% (95% CI 5–18%) in the asymptomatic population, 38% (95% CI − 10 to 85%) in the general population, 15% (95% CI 13–18%) in patients from primary care, 32% (95% CI 22–41%) in patients from secondary care and 21% (95% CI 16–26%) in a mixed population from primary and secondary care.

Conclusions

The mean prevalence estimates based on clinical diagnoses vary between 11 and 39%, and the estimates based on radiological diagnoses similarly vary between 11 and 38%. The results are based on studies with high risk of bias, and the pooled prevalence estimates should therefore be interpreted with caution. With an growing elderly population, there is a need for future low risk-of-bias research clarifying clinical and radiological diagnostic criteria of lumbar spinal stenosis.

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Authors and Affiliations

  1. Department of Sports Science and Clinical Biomechanics, Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark

    Rikke Krüger Jensen, Bart Koes & Jan Hartvigsen

  2. Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark

    Rikke Krüger Jensen, Tue Secher Jensen & Jan Hartvigsen

  3. Department of Diagnostic Imaging, Silkeborg Regional Hospital, Silkeborg, Denmark

    Tue Secher Jensen

  4. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    Tue Secher Jensen

  5. Department of General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands

    Bart Koes

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  1. Rikke Krüger Jensen
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Risk-of-bias assessment tool (PDF 225 kb)

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Jensen, R.K., Jensen, T.S., Koes, B. et al. Prevalence of lumbar spinal stenosis in general and clinical populations: a systematic review and meta-analysis. Eur Spine J 29, 2143–2163 (2020). https://doi.org/10.1007/s00586-020-06339-1

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