Consensus on clinical outcome measures for lumbar spinal stenosis: recommendations from the ISSLS lumbar spinal stenosis taskforce.

PURPOSE

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).

METHODS

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.

RESULTS

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.

CONCLUSION

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.