Anderson David B, Cheung Chelsia, Lane Christy, Melloh Markus, Dvorak Jiri, Van Gelder James M, Wong Arnold
School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Eur Spine J. 2025 Sep 9. doi: 10.1007/s00586-025-09343-5.
The purpose of this study was to determine through a Delphi process a list of outcomes measures for clinicians to use when assessing individuals with Lumbar Spinal Stenosis (LSS).
A three-phase Delphi process was conducted by the International Society for the Study of the Lumbar Spine (ISSLS) Lumbar Spinal Stenosis Taskforce, including two online surveys, two virtual meetings, and three in-person consensus meetings at the ISSLS annual conferences (2023-2025). Participants evaluated and ranked outcome measures for LSS, with final endorsement requiring > 66% agreement.
Across three Delphi phases, 91 international subject matter experts contributed to the evaluation of 138 outcome measures for LSS. Through iterative surveys and consensus meetings, nine outcome measures across six domains -pain, self-reported and objective function, balance, sleep, and recovery- achieved final endorsement by the ISSLS Lumbar Spinal Stenosis Taskforce, each with ≥ 89% agreement. The nine outcome measures were: (1) pain/discomfort in the leg/glute during standing/walking; (2) pain/discomfort in the back during standing/walking; (3) other symptoms during standing/walking; (4) Symptom Severity Scale (Swiss Spinal Stenosis Questionnaire); (5) Oswestry Disability Index (ODI); (6) observed walking distance; (7) single leg stance; (8) ODI sleep item; and (9) Global Perceived Recovery.
The study provides a consensus list of recommended outcome measures for clinicians assessing individuals with a clinical diagnosis of LSS. Although not a definitive core outcome set for routine practice, the list provides practical guidance for selecting appropriate measures for specific assessment domains. We anticipate that the list will be updated as technological advances improve our capacity to assess domains of individuals with LSS.
本研究旨在通过德尔菲法确定临床医生在评估腰椎管狭窄症（LSS）患者时可使用的一系列结局指标。
国际腰椎研究学会（ISSLS）腰椎管狭窄症特别工作组开展了一个三阶段的德尔菲法流程，包括两次在线调查、两次虚拟会议以及在ISSLS年会（2023 - 2025年）上举行的三次面对面共识会议。参与者对LSS的结局指标进行评估和排序，最终认可需要超过66%的一致意见。
在三个德尔菲阶段中，91名国际主题专家参与了对138项LSS结局指标的评估。通过反复的调查和共识会议，六个领域（疼痛、自我报告和客观功能、平衡、睡眠及恢复）中的九项结局指标获得了ISSLS腰椎管狭窄症特别工作组的最终认可，每项指标的认可率均≥89%。这九项结局指标分别为：（1）站立/行走时腿部/臀部的疼痛/不适；（2）站立/行走时背部的疼痛/不适；（3）站立/行走时的其他症状；（4）症状严重程度量表（瑞士腰椎管狭窄症问卷）；（5）奥斯威斯利功能障碍指数（ODI）；（6）观察到的行走距离；（7）单腿站立；（8）ODI睡眠项目；（9）总体感知恢复情况。
本研究为临床医生评估临床诊断为LSS的患者提供了一份推荐结局指标的共识清单。尽管该清单并非常规实践的最终核心结局集，但为特定评估领域选择合适的指标提供了实用指导。我们预计，随着技术进步提高我们评估LSS患者各领域的能力，该清单将得到更新。
