MIČÁNKOVÁ ADAMOVÁ, Blanka, Stanislav VOHÁŇKA, Mária HNOJČÍKOVÁ, Iva OKÁČOVÁ, Ladislav DUŠEK and Josef BEDNAŘÍK. Neurological impairment score in lumbar spinal stenosis. European Spine Journal. Springer, 2013, vol. 22, No 8, p. 1897-1906. ISSN 0940-6719. doi:10.1007/s00586-013-2731-7.
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Basic information
Original name Neurological impairment score in lumbar spinal stenosis
Authors MIČÁNKOVÁ ADAMOVÁ, Blanka (203 Czech Republic, belonging to the institution), Stanislav VOHÁŇKA (703 Slovakia, belonging to the institution), Mária HNOJČÍKOVÁ (203 Czech Republic, belonging to the institution), Iva OKÁČOVÁ (203 Czech Republic, belonging to the institution), Ladislav DUŠEK (203 Czech Republic, belonging to the institution) and Josef BEDNAŘÍK (203 Czech Republic, guarantor, belonging to the institution).
Edition European Spine Journal, Springer, 2013, 0940-6719.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30000 3. Medical and Health Sciences
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 2.473
RIV identification code RIV/00216224:14740/13:00069336
Organization unit Central European Institute of Technology
Doi http://dx.doi.org/10.1007/s00586-013-2731-7
UT WoS 000322722900034
Keywords in English Oswestry Disability Index; Lumbar spinal stenosis; Neuromuscular impairment; Neurogenic claudication
Tags ok, podil, rivok
Tags International impact, Reviewed
Changed by Changed by: Olga Křížová, učo 56639. Changed: 21. 1. 2014 09:10.
Abstract
BACKGROUND AND AIM: The Oswestry Disability Index (ODI) is an interview-based 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 (NIS-LSS)] 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 LSS. METHODS: The NIS-LSS 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 sex-matched healthy volunteers were assessed with the NIS-LSS to evaluate capacity to discriminate between LSS patients and controls. A correlation with the ODI was performed for assessment of construct validity. RESULTS: The median NIS-LSS was 27 points in LSS patients compared with 33 points in controls. The NIS-LSS discriminated LSS patients from healthy controls to a high degree of significance: the optimum NIS-LSS cut-off value was 32 points with a sensitivity of 85.5 % and a specificity of 81.3 % (p < 0.001). Overall NIS-LSS correlated significantly with the ODI score (p < 0.001). Vibratory sensation (p = 0.04), presence of paresis (p = 0.01) and especially the ability to walk and run (p < 0.001) were the NIS-LSS elements that correlated most closely with the degree of disability assessed by the ODI. CONCLUSIONS: The NIS-LSS 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.
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