Comparison of the history and physical examination for hip osteoarthritis and lumbar spinal stenosis

Abstract Background: Lumbar spinal stenosis (LSS) and knee and hip osteoarthritis (OA) are prevalent conditions in the aging population and previous literature suggests they share many symptoms and are present at the same time in patients. However, no prevalence estimates of multimorbid LSS and knee and/or hip OA are currently available. The primary objective of this systematic review is therefore to estimate the prevalence of multimorbid LSS with knee and/or hip OA using radiological, clinical, and combined case definitions. Methods: This systematic review protocol has been designed according to the guidelines from the Cochrane Collaboration and are reported according the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. A comprehensive search will be performed in the following databases: MEDLINE, EMBASE, CENTRAL, and CINAHL. Web of Science will be used for forward citation tracking. No restriction in the search for publication data and language will be applied, but only articles in English will be included. The search strategy will include the following domains: LSS, knee OA, and hip OA. Retrieved citations will be screened by two authors independently. Disagreements will be discussed until consensus, or a third reviewer will be consulted if consensus cannot be reached. Data extraction and assessment of methodological quality will be done by two authors independently, using a standardized data extraction form and modified Risk of Bias Tool for Prevalence studies. Meta-analysis estimating prevalence with 95% CI will be performed using a random effects model. Meta-regression analyses will be performed to investigate the impact of LSS clinical presentations, sample population, healthcare setting, risk of bias, and other patient characteristics on prevalence estimates for multimorbid LSS and knee and/or hip OA. Discussion: The results of this review will provide the first estimates of the prevalence of multimorbid LSS and hip and knee OA based on various case definitions. The impact of covariates such as LSS clinical presentations, sample population, healthcare setting, risk of bias, and patient characteristics on prevalence estimates will also be presented. These findings will help to better understand the relationship between LSS and knee and/or hip OA and identify future research priorities. Systematic review registration: Submitted to PROSPERO, awaiting registration Keywords: Lumbar spinal stenosis, Hip osteoarthritis, Knee osteoarthritis, Multimorbidity, Prevalence, Systematic review protocol

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OPTIMIZATION OF SURGICAL TREATMENT TACTICS FOR PATIENTS WITH HIP-SPINE SYNDROME: A CLINICAL CASE

Rheumatology Science and Practice ◽

10.14412/1995-4484-2019-474-477 ◽

2019 ◽

Vol 57 (4) ◽

pp. 474-477

Author(s):

A. A. Kargaltsev ◽

M. A. Makarov ◽

V. N. Amirdzhanova

Keyword(s):

Surgical Treatment ◽

Peripheral Neuropathy ◽

Medical Treatment ◽

Female Patient ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Clinical Case ◽

Hip Osteoarthritis ◽

Central Problem ◽

Lumbar Spinal

Coexisting hip osteoarthritis (OA) and lumbar spinal stenosis (central and foraminal) and/or spondylolisthesis is called a hip-spine syndrome (HSS). The central problem is correctly diagnosing and determining the tactics of surgical or medical treatment for patients with HSS. The paper describes a clinical case of a female patient with HSS and an examination algorithm for determining the significance of peripheral neuropathy and hip OA and discusses the choice of surgical treatment tactics.

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SIZE study: study protocol of a multicentre, randomised controlled trial to compare the effectiveness of an interarcuair decompression versus extended decompression in patients with intermittent neurogenic claudication caused by lumbar spinal stenosis

BMJ Open ◽

10.1136/bmjopen-2020-036818 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036818

Author(s):

Jamie Arjun Sharma ◽

Pravesh S. Gadjradj ◽

Wilco C. Peul ◽

Maurits W. van Tulder ◽

Wouter A. Moojen ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Physical Examination ◽

Functional Status ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Controlled Trial ◽

Clinical Indication ◽

Neurogenic Claudication ◽

Randomised Controlled ◽

Lumbar Spinal

IntroductionIntermittent neurogenic claudication (INC) is often caused by lumbar spinal stenosis (LSS). Laminectomy is considered a frequently used surgical technique for LSS. Previous studies have shown that laminectomy can potentially cause lumbar instability. Less invasive techniques, preserving midline structures including the bilateral small size interarcuair decompression, are currently applied. Due to lack of evidence and consensus, surgeons have to rely on their training and own experiences to choose the best surgical techniques for their patients. Hence, an observer and patient blinded multicentre, randomised controlled trial was designed to determine the effectiveness and cost-effectiveness of bilateral interarcuair decompression versus laminectomy for LSS.Methods and analysis174 patients above 40 years with at least 12 weeks of INC will be recruited. Patients are eligible for inclusion if they have a clinical indication for surgery for INC with an MRI showing signs of LSS. Patients will be randomised to laminectomy or bilateral interarcuair decompression. The primary outcome is functional status measured with the Roland-Morris Disability Questionnaire at 12 months. Secondary outcomes consist of pain intensity, self-perceived recovery, functional status measured with the Oswestry Disability Index and a physical examination. Outcome measurement moments will be scheduled at 3 and 6 weeks, and at 3, 6, 12, 18, 24, 36 and 48 months after surgery. Physical examination will be performed at 6 weeks, and 12, 24 and 48 months. An economic evaluation will be performed and questionnaires will be used to collect cost data.Ethics and disseminationThe Medical Ethical Committee of the Erasmus Medical Centre Rotterdam approved this study (NL.65826.078.18). The results will be published in an international peer-reviewed journal.Trial registration numberClinicalTrials.gov (NCT03480893).IRB approval statusMEC-2018-093.

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