The diagnostic value of ｇait load test for lumbar spinal stenosis

English Keywords:Lumbar spinal stenosis  Intermittent claudication  Gait load test  EMG

English Abstract:

  【Abstract】 Objective：To assess the clinical efficacy of gait load test in the diagnosis of lumbar spinal stenosis by evaluating its coincidence with the lumbar MRI scan and EMG examination.Method：35 patients with lumbar spinal stenosis between October 2009　and October 2010　in our hospital，had severe symptoms but no obvious signs.All the cases were on the radiological examination（including lumbar X-ray of AP view，lateral view，lateral view of flexion and extension，lumbar MRI and color Doppler of lower limb vessels）.Double blind detection and assessment were performed for lower limb electromyography and gait load test results.The segments of the impaired nerve roots corresponding to specific positive symptoms（sensation，strength，reflexes and other changes） were noted after the gait load test and compared with the sites of lumbar spinal stenosis from lumbar MRI and EMG.Results：29 patients had symptoms after the gait load test.Physical examination demonstrated the number of the impaired segmental nerve roots of L1-2，L2-3，L3-4，L4-5，L5-S1.The number of segments was 1，1，12，23，16 respectively，in which the single level was 10（34.5%），while two-level amounted 14（48.3%）　and three-level 5（17.2%）.Radiological examination showed the number of the stenotic spinal segments of L1/2，L2/3，L3/4，L4/5，L5/S1.The number of segments was 2，2，15，25，18 respectively，in which the single level was 14（40%），while two-level amounted 15（42.9%） and three-level 6（17.1%）.EMG examination showed that 31 patients（88.6%） were positive，while 4 patients（11.4%） were negative.All the patients positive for gait load tests had abnormal findings under EMG（100%）.There was no significant difference in diagnosis of the lower lumbar spinal stenosis（L3/4，L4/5，L5/S1） between gait load test and lumbar MRI（P>0.05）.Conclusions：The gait load test had good coincidence with the lumbar MRI scan and EMG examination in diagnosis of the lower lumbar spinal stenosis.There was an important diagnostic value for lumbar spinal stenosis patients.