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Meta-Analysis
. 2013 Aug 30;2013(8):CD010712.
doi: 10.1002/14651858.CD010712.

Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication

Carlo Ammendolia  1 , Kent J Stuber, Elisabeth Rok, Raja Rampersaud, Carol A Kennedy, Victoria Pennick, Ivan A Steenstra, Linda K de Bruin, Andrea D Furlan
Affiliations
Meta-Analysis

Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication

Carlo Ammendolia et al. Cochrane Database Syst Rev. .

Abstract

Background: Lumbar spinal stenosis with neurogenic claudication is one of the most commonly diagnosed and treated pathological spinal conditions. It frequently afflicts the elderly population.

Objectives: To systematically review the evidence for the effectiveness of nonoperative treatment of lumbar spinal stenosis with neurogenic claudication.

Search methods: CENTRAL, MEDLINE, CINAHL, and Index to Chiropractic Literature (ICL) databases were searched up to June 2012.

Selection criteria: Randomized controlled trials published in English, in which at least one arm provided data on nonoperative treatments

Data collection and analysis: We used the standard methodological procedures expected by The Cochrane Collaboration. Risk of bias in each study was independently assessed by two review authors using the 12 criteria recommended by the Cochrane Back Review Group (Furlan 2009). Dichotomous outcomes were expressed as relative risk, continuous outcomes as mean difference or standardized mean difference; uncertainty was expressed with 95% confidence intervals. If possible a meta-analysis was performed, otherwise results were described qualitatively. GRADE was used to assess the quality of the evidence.

Main results: From the 8635 citations screened, 56 full-text articles were assessed and 21 trials (1851 participants) were included. There was very low-quality evidence from six trials that calcitonin is no better than placebo or paracetamol, regardless of mode of administration or outcome assessed. From single small trials, there was low-quality evidence for prostaglandins, and very low-quality evidence for gabapentin or methylcobalamin that they improved walking distance. There was very low-quality evidence from a single trial that epidural steroid injections improved pain, function, and quality of life, up to two weeks, compared with home exercise or inpatient physical therapy. There was low-quality evidence from a single trial that exercise is of short-term benefit for leg pain and function compared with no treatment. There was low and very low-quality evidence from six trials that multimodal nonoperative treatment is less effective than indirect or direct surgical decompression with or without fusion. A meta-analysis of two trials comparing direct decompression with or without fusion to multimodal nonoperative care found no significant difference in function at six months (mean difference (MD) -3.66, 95% CI -10.12 to 2.80) and one year (MD -6.18, 95% CI -15.03 to 2.66), but at 24 months a significant difference was found favouring decompression (MD -4.43, 95% CI -7.91 to -0.96).

Authors' conclusions: Moderate and high-quality evidence for nonoperative treatment is lacking and thus prohibits recommendations for guiding clinical practice. Given the expected exponential rise in the prevalence of lumbar spinal stenosis with neurogenic claudication, large high-quality trials are urgently needed.

PubMed Disclaimer

Conflict of interest statement

The principal author received funding from the Canadian Chiropractic Research Foundation.

Figures

1
1
Selection process of included articles.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Forest plot of comparison: 1 Direct decompression ± fusion versus multimodal nonoperative care for Oswestry Disability Index, outcome: 1.1 Oswestry Disability Index.
1.1
1.1. Analysis
Comparison 1 Direct Decompression ± fusion versus multimodal nonoperative care for Oswestry Disability Index, Outcome 1 Oswestry Disability Index.
See this image and copyright information in PMC

References

References to studies included in this review

Amundsen 2000 {published data only}
    1. Amundsen T, Weber H, Nordal HJ, Magnaes B, Abdelnoor M, Lilleas F. Lumbar spinal stenosis: conservative or surgical management?: A prospective 10‐year study. Spine 2006;25(11):1424‐35. - PubMed
Cuckler 1985 {published data only}
    1. Cuckler JM, Bernini PA, Wiesel SW, Booth RE Jr, Rothman RH, Pickens GT. The use of epidural steroids in the treatment of lumbar radicular pain. A prospective, randomized, double blind study. The Journal of Bone and Joint Surgery. American volume 1985;67(1):63‐6. - PubMed
Eskola 1992 {published data only}
    1. Eskola A, Pohljolainen T, Alaranta H, Soini J, Tallroth K, Slatis P. Calcitonin treatment in lumbar spinal stenosis: a randomized, placebo‐controlled, double‐blind, cross‐over study with one year follow‐up. Calcified Tissue International 1992;50(5):400‐3. - PubMed
Fukusaki 1988 {published data only}
    1. Fukusaki M, Kobayashi I, Hara T, Sumikawa K. Symptoms of spinal stenosis do not improve after epidural steroid injection. Clinical Journal of Pain 1998;14(2):148‐51. - PubMed
Goren 2010 {published data only}
    1. Goren A, Yildiz N, Topuz O, Findikoglu G, Ardic F. Efficacy of exercise and ultrasound in patients with lumbar spinal stenosis: a prospective randomized controlled trial. Clinical Rehabilitation 2010;24(7):623‐31. - PubMed
Koc 2009 {published data only}
    1. Koc Z, Ozcakir S, Sivrioglu K, Gurbet A, Kucukoglu S. Effectivness of physical therapy and epidural steroid injections in lumbar spinal stenosis. Spine 2009;34(10):985‐9. - PubMed
Malmivaara 2007 {published data only}
    1. Malmivaara A, Slatis P, Heliovaara M, Sainio P, Kinnunen H, Kankare J, et al. Surgical or non‐operative treatment for lumbar spinal stenosis? A randomized controlled trial. Spine 2007;32(1):1‐8. - PubMed
    1. Slatis P, Malmivaara A, Heliovaara M, Sianio P, Herno A, Kankare J, et al. Long‐term results of surgery for lumbar spinal stenosis: a randomised controlled trial. European Spine Journal 2011;20:1174‐81. - PMC - PubMed
Matsudaira 2009 {published data only}
    1. Matsudaira K, Seichi A, Kunogi J, Yamazaki T, Kobayahi A, Anamizu Y, et al. The efficacy of prostaglandin E1 derivative in patients with lumbar spinal stenosis. Spine 2009;34(2):115‐20. - PubMed
Podichetty 2004 {published data only}
    1. Podichetty VK, Segal AM, Lieber M, Mazanee DJ. Effectiveness of salmon calcitonin nasal spray in the treatment of lumbar canal stenosis: a double‐blind, randomized, placebo‐controlled, parallel group tiral. Spine 2004;29(21):2343‐9. - PubMed
Porter 1983 {published data only}
    1. Porter RW, Hibbert C. Calcitonin treatment for neurogenic claudication. Spine 1983;8(6):585‐92. - PubMed
Porter 1988 {published data only}
    1. Porter RW, Miller CG. Neurogenic claudication and root claudication treated with calcitonin. A double‐blind trial. Spine 1988;13(9):1061‐4. - PubMed
Pua 2007 {published data only}
    1. Pua YH, Cai CC, Lim KC. Treadmill walking with body weight support is no more effective than cycling when added to an exercise program for lumbar spinal stenosis: a randomised controlled trial. Australian Journal Physiotherapy 2007;53(2):83‐9. - PubMed
Sahin 2009 {published data only}
    1. Sahin F, Yilmaz F, Kotevoglu N, Kuran B. The efficacy of physical therapy and physical therapy plus calcitonin in the treatment of lumbar spinal stenosis. Yonsei Medical Journal 2009;50(5):683‐8. - PMC - PubMed
Tafazal 2007 {published data only}
    1. Tafazal SI, Ng L Sell P. Randomised placebo‐controlled trial on the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis. European Spine Journal 2007;16(2):207‐12. - PMC - PubMed
Waikakul 2000 {published data only}
    1. Waikakul W, Waikakul S. Methylcobalamin as an adjuvant medication in conservative treatment of lubmar spinal stenosis. Journal Medical Association Thailand 2000;83(8):825‐31. - PubMed
Weinstein 2007 {published data only}
    1. Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson AN, Blood EA, et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. The New England Journal of Medicine 2007;356(22):2257‐70. - PMC - PubMed
    1. Weinstein JN, Lurie JD, Tosteson TD, Zhao W, Blood EA, Tosteson AN, et al. Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. four‐year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts. The Journal of Bone and Joint Surgery. American volume 2009;91(6):1295‐304. - PMC - PubMed
Weinstein 2008 {published data only}
    1. Weinstein JN, Tosteson TD, Lurie JD, Tosteson A, Blood E, Herkowitz H, et al. Surgical versus nonoperative treatment for lumbar spinal stenosis four‐year results of the Spine Patient Outcomes Research Trial. Spine 2010;35:1329‐38. - PMC - PubMed
    1. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Blood E, Hanscom B, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. The New England Journal of Medicine 2008;358(8):794‐810. - PMC - PubMed
Whitman 2006 {published data only}
    1. Whitman JM, Flynn TW, Childs JD, Wainner RS, Gill HE, Ryder MG, et al. A comparision between two physical therapy treatment programs for patients with lumbar spinal stensosis: a randomized clinical trial. Spine 2006;31(22):2541‐9. - PubMed
Yaski 2007 {published data only}
    1. Yaksi A, Ozgonenel L, Ozgonenel B. The efficacy of gabapentin therapy in patients with lumbar spinal stenosis. Spine 2007;32(9):939‐42. - PubMed
Zahaar 1991 {published data only}
    1. Zahaar M. The value of caudal epidural steroid in the treatment of lumbar neurogenic syndromes. Journal of Neurological and Orthopaedic Medicine and Surgery 1991;12:181‐4.
Zucherman 2004 {published data only}
    1. Anderson PA, Tribus CB, Kitchel SH. Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis. Journal of Neurosurgery. Spine 2006;4(6):463‐71. - PubMed
    1. Zucherman JF, Hsu KY, Hartjen CA, Mehalic TF, Implicito DA, Martin MJ, et al. A prospective randomized multi‐center study for the treatment of lumbar spinal stenosis with the X STOP interspinous implant: 1‐year results. European Spine Journal 2004;13(1):22‐31. - PMC - PubMed

References to studies excluded from this review

Akyol 2009 {published data only}
    1. Akyol Y, Durmus D, Alayli G, Tander B, Ulus Y, Canturk F. Effectiveness of physical therapy agents in patients with lumbar spinal stenosis. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi 2009;55(4):140‐6.
Canovas 2009 {published data only}
    1. Canovas L, Castro M, Martinez‐Salgado J, Vila S, Centeno y F, Rocha J. Sciatica: Intradiscal ozone administration associated with pulsed radiofrequency of the dorsal root ganglia compared with the isolated use of each of these two techniques [Ciatica: tratamiento con ozono intradiscal y radiofrecuencia del ganglio de la raiz dorsal frente a cada una de estas dos tecnicas]. Revista de la Sociedad Espanola del Dolor 2009;16(3):141‐6.
Comer 2010 {published data only}
    1. Comer CM, Johnson MI, Marchant PR, Redmond AC, Bird HA, Conaghan PG. The effectiveness of walking stick use for neurogenic claudication: results from a randomized trail and the effects on walking tolerance and posture. Archives of Physical Medicine and Rehabilitation 2010;91(1):15‐19. - PubMed
Ghosh 1981 {published data only}
    1. Ghosh P, Taylor TK, Meachin AD. A double blind crossover trial of indomethacin flurbiprofen and placebo in the management of lumbar spondylosis. Current Therapeutic Research, Clinical and Experimental 1981;30(3):318‐26.
Huda 2010 {published data only}
    1. Huda N, Bansal P, Gupta SM, Ruhela A, Rehman M, Afzal M. The efficacy of epidural depo‐methylprednisolone and triamcinolone acetate in relieving the symptoms of lumbar canal stenosis: A comparative study. Journal of Clinical and Diagnostic Research 2010;4(4):2842‐7.
Khoromi 2007a {published data only}
    1. Khoromi S, Blackman MR, Kingman A, Patsalides A, Matheny LA, Adams S, et al. Low intensity permanent magnets in the treatment of chronic lumbar radicular pain. Journal of Pain and Symptom Management 2007;34(4):434‐45. - PubMed
Khoromi 2007b {published data only}
    1. Khoromi S, Cui L, Nackers L, Max MB. Morphine, nortriptyline and their combination vs. placebo in patients with chronic lumbar root pain. Pain 2007;130(1‐2):66‐75. - PMC - PubMed
Lee 2003 {published data only}
    1. Lee JH, An JH, Lee SH. Comparison of the effectiveness of interlaminar and bilateral transforaminal epidural steroid injections in treatment of patients with lumboscarl disc herniation and spinal stenosis. The Clinical Journal of Pain 2003;25(3):206‐10. - PubMed
Levendogluo 2009 {published data only}
    1. Levendoglu F, Oguz H, Polat E, Bodur S. The effect of corset on walking time in lumbar spinal stenosis. Turkiye Klinikleri Journal of Medical Sciences 2009;29(5):1172‐7.
Makki 2010 {published data only}
    1. Makki D, Nawabi DH, Francis R, Hamed AR, Hussein AA. Is the outcome of caudal epidural injections affected by patient positioning?. Spine 2010;35(15):E687‐90. - PubMed
Manchikanti 2008 {published data only}
    1. Manchikanti L, Cash KA, McManus CD. Preliminary results of a randomized, equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain: Part 4 ‐ Spinal stenosis. Pain Physician 2008;11(6):833‐48. - PubMed
Mariconda 2002 {published data only}
    1. Mariconda M, Fava R, Gatto A, Longo C, Milano C. Unilateral laminectomy for bilateral decompression of lumbar spinal stenosis: a prospective comparative study with conservatively treated patients. Journal of Spinal Disorders & Techniques 2002;15(1):39‐46. - PubMed
Mathews 1975 {published data only}
    1. Mathres JA, Hickling J. Lumbar traction: a double‐blind controlled study for sciatica. Rheumatology and Rehabilitation 1975;14(4):222‐5. - PubMed
Ng 2005 {published data only}
    1. Ng L, Chaudhary N, Sell P. The efficacy of corticosteroids in periradicular infiltration for chronic radicular pain: a randomized, double‐blind, controlled trial. Spine 2005;30(8):857‐62. - PubMed
Oguz 2007 {published data only}
    1. Oguz H, Levendoglu F, Ogun TC, Tantug A. Loading is more effective than posture in lumbar spinal stenosis: a study with treadmill equipment. European Spine Journal 2007;16(7):913‐8. - PMC - PubMed
Owlia 2007 {published data only}
    1. Owlia MD, Salimzadeh A, Alishiri G, Haghighi A. Comparison of two doses of corticosteroid in epidural steroid injection for lumbar radicular pain. Singapore Medical Journal 2003;48(3):241‐5. - PubMed
Paker 2005 {published data only}
    1. Paker N, Turkmen C, Bugdayci D, Tekdos D, Erbil M. Comparison of conservative and surgical treatment results in lumbar spinal stenosis. Turkish Neurosurgery 2005;15(4):182‐4.
Price 2000 {published data only}
    1. Price CM, Rogers PD, Prosser AD, Arden NK. Comparison of the caudal and lumbar approaches to the epidural space. Annals of the Rheumatic Diseases 2000;59(11):879‐82. - PMC - PubMed
Price 2005 {published data only}
    1. Price C, Arden N, Coglan L, Rogers P. Cost‐effectiveness and safety of epidural steroids in the management of sciatica. Health Tecnology Assessment 2005;9(33):1‐58. - PubMed
Riew 2000 {published data only}
    1. Riew KD, Yin Y, Gilula L, Bridwell KH, Lenke LG, Lauryssen C, et al. The effect of nerve‐root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double‐blind study. The Journal of Bone and Joint Surgery. American volume 2000;82‐A(11):1589‐93. - PubMed
Riew 2008 {published data only}
    1. Riew KD, Park JB, Cho Y, Gilula L, Patel A, Lenke L, et al. Nerve root blocks in the treatment of lumbar radicular pain. A minimum five‐year follow‐up. The Journal of Bone and Joint Surgery. American volume 2006;88(8):1722‐5. - PubMed
Sell 2006 {published data only}
    1. Sell P, Tafazal S, Ng L. Randomised double blinded placebo‐controlled trial on the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis. European Spine Journal 2006;15 Suppl 4:S487. - PMC - PubMed
Simopoulos 2003 {published data only}
    1. Simopoulos TT, Kraemer J, Nagda JV, Aner M, Bajwa ZH. Response to pulsed and continuous radiofrequency lesioning of the dorsal root ganglion and segmental nerves in patients with chronic lumbar radicular pain. Pain Physician 2003;11(2):137‐44. - PubMed
Thackeray 2009 {published data only}
    1. Thackeray A, Fritz J, Brennan GP, Zaman FM. Effectiveness of physical therapy as an adjunct to a selective nerve root block for treatment of lumbar radicular pain. Journal of Orthopaedic and Sports Physical Therapy 2009;39(1):A16‐7. - PubMed
Wiilson‐MacDonald 2005 {published data only}
    1. Wilson‐Macdonald J, Burt G, Griffin D, Glynn C. Epidural steroid injection for nerve root compression. The Journal of Bone and Joint Surgery ‐ Series B 2005;87(3):352‐5. - PubMed
Wu 2003 {published data only}
    1. Wu Y, Li JS, Jia LS. Comparing the therapeutic efficacy between conservative therapy and unilateral laminectomy for bilateral decompression of lumbar spinal stenosis. The Journal of Cervicodynia & Lumbodynia 2003;24(4):210‐3.

Additional references

AHRQ 2001
    1. Treatment of degenerative lumbar spinal stenosis. Evidence report/technology assessment no. 32. Agency for Healthcare Research and Quality 2001; Vol. Report No.: AHRQ01‐E048.
Boden 1990
    1. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic‐resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. The Journal of Bone and Joint Surgery. American volume 1990;72(3):403‐8. - PubMed
Boutron 2005
    1. Boutron I, Moher D, Tugwell P, Giraudeau B, Poiraudeau S, Nizard R, et al. A checklist to evaluate a report of a non pharmacological trial (CLEAR NPT) was developed using consensus. Journal of Clinical Epidemiology 2005;58:1233‐40. - PubMed
Brouwer 2004
    1. Brouwer S, Kuijer W, Dijkstra PU, Göeken LN, Groothoff JW, Geertzen JH. Reliability and Stability of the Roland Morris Disability Questionnaire: intra class correlation and limits of agreement. Disability and Rehabilitation 2004;26(3):162‐5. - PubMed
Chou 2007
    1. Chou R, Qaseem A, Snow V, Casey D, Cross J, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine 2007;147(7):478‐91. - PubMed
Chou 2009
    1. Chou R, Loeser JD, Owens DK, Rosenquist RW, Atlas SJ, Baisden J, et al. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence‐based clinical practice guideline from the American Pain Society. Spine 2009;34(10):1066‐77. - PubMed
Chou 2009b
    1. Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD. Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline. Spine 2009;34(10):1094‐109. - PubMed
Comer 2009
    1. Comer CM, Redmond AC, Bird HA, Conaghan PG. Assessment and management of neurogenic claudication associated with lumbar spinal stenosis in a UK primary care musculoskeletal service: a survey of current practice among physiotherapists. BMC Musculoskeletal Disorders 2009;10:121. - PMC - PubMed
Comer 2011
    1. Comer CM, Conaghan PG, Tennant A. Internal construct validity of the Swiss Spinal Stenosis Questionnaire: Rasch analysis of a disease‐specific outcome measure for lumbar spinal stenosis. Spine 2011;36(23):1967‐76. - PubMed
Deyo 2010
    1. Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG. Trends, major medical complications and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA 2010;303(13):1259‐65. - PMC - PubMed
Fairbank 1980
    1. Fairbank JC, Couper J, Davies JB, O’Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy 1980;14(8):271‐3. - PubMed
Furlan 2009
    1. Furlan AD, Pennick V, Bombardier C, Tulder M. 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine 2009;34(18):1929‐41. - PubMed
Genevay 2010
    1. Genvay S, Atlas SJ, Katz JN. Variation in eligibility criteria from studies of radiculopathy due to a herniated disc and of neurogenic claudication due to lumbar spinal stenosis: a structured literature review. Spine 2010;35(7):803‐11. - PMC - PubMed
Government of Canada 2006
    1. Government of Canada. Statistics Canada. Statistics Canada 2006. www.statcan.gc.ca/bsolc/olc‐cel/olc‐cel?lang=eng&catno=11‐008‐X.
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Iwamoto 2010
    1. Iwamoto J, Sato Y, Takeda T, Matsumoto H. Effectiveness of exercise in the treatment of lumbar spinal stenosis, knee osteoarthritis, and osteoporosis. Aging Clinical and Experimental Research 2010;22(2):116‐22. - PubMed
Kabir 2010
    1. Kabir SM, Gupta SR, Casey AT. Lumbar interspinous spacers: a systematic review of clinical and biomechanical evidence. Spine 2010;35(25):E1499‐506. - PubMed
Katz 2008
    1. Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. The New England Journal of Medicine 2008;358(8):818‐25. - PubMed
Kovacs 2011
    1. Kovacs FM, Urrutia G, Alarcon JD. Surgery versus conservative treatment for symptomatic lumbar spinal stenosis. Spine 2011;36(20):E1335‐51. - PubMed
Melzack 2005
    1. Melzck R. The McGill Pain Questionnaire: from description to measurement. Anesthesiology 2005;103(1):199‐202. - PubMed
Podichetty 2011
    1. Podichetty VK, Varley ES, Lieberman I. Calcitonin treatment in lumbar spinal stenosis: a meta‐analysis. Spine 2011;36(5):E357‐64. - PubMed
Stucki 1996
    1. Stucki G, Daltroy L, Liang MH, Lipson SJ, Fossel AH, Katz JN. Measurement properties of a self‐administered outcome measure in lumbar spinal stenosis. Spine 1996;21(7):796‐803. - PubMed
Suri 2010
    1. Suri P, Rainville J, Kalichman L, Katz JN. Does this older adult with lower extremity pain have the clinical syndrome of lumbar spinal stenosis?. JAMA 2010;304(23):2628‐36. - PMC - PubMed
Tomkins 2009
    1. Tomkins CC, Battie MC, Rogers T, Jiang H, Petersen S. A criterion measure of walking capacity in lumbar spinal stenosis and its comparison with a treadmill protocol. Spine 2009;34(22):2444‐9. - PubMed
van Tulder 2003
    1. Tulder M, Furlan A, Bombardier C, Bouter L, Editorial Board Cochrane Back Review Group. Updated method guidelines for systemic reviews in the Cochrane Collaboration Back Review Group. Spine 2003;28(12):1290‐9. - PubMed
Ware 1995
    1. Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF‐36 health profile and summary measures: summary of results from the Medical Outcomes Study. Medical Care 1995;33:AS264‐79. - PubMed
Winter 2010
    1. Winter CC, Brandes M, Muller C, Schubert T, Ringling M, Hillmann A, et al. Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis: a cross‐sectional study. BMC Musculoskeletal Disorders 2010;11:233. - PMC - PubMed

References to other published versions of this review

Ammendolia 2012
    1. Ammendolia C, Stuber K, Bruin LK, Furlan AD, Kennedy CA, Rampersaud YR, et al. Nonoperative treatment of lumbar spinal stenosis with neurogenic claudication. Spine 2012;37(10):E609‐16. [DOI: 10.1097/BRS.0b013e318240d57d] - DOI - PubMed

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