Validity of a test for diagnosing lumbar spinal stenosis
Current practice is in need of robust clinical tests to facilitate diagnosis and guide treatment. The current validation study sought to identify the modified extension test (MExT) as a diagnostic tool for acquired lumbar spinal stenosis (ALSS). The results revealed a highly sensitive but poorly specific test.
Lower back pain is an epidemic that has shown its effects all over the world, none more notable than its effects on disability. ALSS represents a degenerative sub-classification of back pain that is well-represented in an aging population, however, lacks a clinical diagnostic test sufficient to assist medical examination. Thus, the authors have pursued the validation of MExT as a diagnostic test as well sought to identify its correlation to grading and location.
The population represented those aged 50 years and older with a 6-week history of accepted symptomology for ALSS and compared against ensuing findings on MRI. Tests for sensitivity, specificity, and likelihood ratios were used in analysis of data to determine test performance and validity.
Results of the current study revealed a MExT to have a high sensitivity that lends support in ruling out a diagnosis of ALSS. The low specificity however, did not meet a clinical level of acceptability to aid in ruling in ALSS. Further analysis failed to find significant correlation between grade or location. It was suggested further large center trials would be needed to affirm the validity of MExT for ALSS.
> From: Dobbs, Man Ther 25 (2017) 27-34. All rights reserved to Elsevier Ltd. Click here for the online summary.