Authors: B Micankova Adamova S Vohanka M Hnojcikova I Okacova L Dusek J Bednarik
Publish Date: 2013/03/13
Volume: 22, Issue: 8, Pages: 1897-1906
Abstract
The Oswestry Disability Index ODI is an interviewbased instrument generally accepted as a measure of disability in patients with lumbar spinal stenosis LSS There is however no generally accepted measure for neurological impairment in LSS We therefore developed a scoring system neurological impairment score in lumbar spinal stenosis NISLSS for the assessment of neurological impairment in the lower limbs of patients with LSS then performed a validation study to facilitate its implementation in the routine clinical evaluation of patients with LSSThe NISLSS is based on the combined evaluation of tendon reflexes tactile and vibratory sensation pareses and the ability to walk and run the total score ranges from 0 inability to walk to 33 points no impairment A group of 117 patients with LSS and a control group of 63 age and sexmatched healthy volunteers were assessed with the NISLSS to evaluate capacity to discriminate between LSS patients and controls A correlation with the ODI was performed for assessment of construct validityThe median NISLSS was 27 points in LSS patients compared with 33 points in controls The NISLSS discriminated LSS patients from healthy controls to a high degree of significance the optimum NISLSS cutoff value was 32 points with a sensitivity of 855 and a specificity of 813 p 0001 Overall NISLSS correlated significantly with the ODI score p 0001 Vibratory sensation p = 004 presence of paresis p = 001 and especially the ability to walk and run p 0001 were the NISLSS elements that correlated most closely with the degree of disability assessed by the ODIThe NISLSS is a simple and valid measure of neurological impairment in the lower limbs of patients with LSS without comorbidity discriminating them from healthy controls to a high degree of sensitivity and specificity and correlating closely with the degree of disability It extends our ability to quantify neurological status and to follow changes arising out of the natural course of the disease or the effects of treatment
Keywords: