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Jensen 2020 — prevalence of lumbar spinal stenosis

One-paragraph summary

The review included 41 papers reporting 55 samples and pooled lumbar-stenosis prevalence separately by clinical versus radiological definition and care setting. Clinically defined prevalence was 11% (95% CI 4–18%) in general populations, 25% (19–32%) in primary care, 29% (22–36%) in secondary care and 39% in mixed-care samples. Radiological prevalence was 11% (5–18%) in asymptomatic samples and varied from 15% to 32% across clinical settings. Two-thirds of included papers were at high risk of bias (Jensen 2020, PMID 32095908).

Key findings

  • Definition and referral setting changed estimates by more than threefold.
  • Imaging-only stenosis occurred in 11% (95% CI 5–18%) of asymptomatic samples.
  • The radiological general-population estimate was 38% with an unusably wide 95% CI from −10% to 85%, exposing sparse and heterogeneous data.
  • A single prevalence number without case definition and setting is not interpretable.

Limitations

  • Two-thirds of studies had high risk of bias.
  • Clinical and radiological thresholds varied across studies.
  • Some pooled strata were small enough to produce implausible confidence limits.

Why it matters

This paper makes the case-definition problem quantitative. It prevents imaging prevalence from being mislabeled as symptomatic disease and supplies the denominator framework for the statistics layer.

Cited by wiki pages

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