ABSTRACT
Background: With increased restrictions following the COVID-19 pandemic, use of virtual care has shown an appreciable rise in clinical practice. Use of self-administrated surveys in triaging patients with low back pain assists with prioritizing care. The objective of this study was to assess the diagnostic value of a self-administrated, self-reported history questionnaire (SSHQ) in diagnosing patients with lumbar spinal stenosis (LSS), using combined clinical and imaging results as the gold standard. The SSHQ has 4 questions that all need to be true for a positive diagnosis of LSS. Methods: Patients with low back pain with and without leg symptoms who had a telephone interview with an advanced practice physiotherapist as a part of a new virtual care initiative were included. A score of 4 points on Q1-Q4 was indicative of the presence of LSS. The relationship between the SSHQ and the Oswestry Disability Index (ODI), the STarT Back questionnaire and the 5-repetition sit-to-stand Test was explored. Results: Data for 57 patients, of whom 26 were female (46%), with a mean age of 57 (standard deviation 17) years were analyzed. The majority of the patients had a diagnosis of radiculopathy (19 [33%] claudication type and 19 [33%] disc related). Of the remaining patients, 9 (16 %) had a mechanical low back pain, 5 (9%) had neurogenic claudication with bilateral symptoms, 3 (5 ) had degenerative disc disease and 2 (4 %) had peripheral joint involvement with referred pain. The SSHQ score did not correlate with the ODI, STarT Back or performance measure scores. The SSHQ did not differentiate the claudication-type radiculopathy or neurogenic claudication from the disc-related radiculopathy or other diagnoses. Patients whose symptoms were reduced by bending forward as the typical sign of LSS had a significantly lower STarT Back score (p = 0.015), indicating less risk of physical or psychological disability. Conclusion: The SSHQ did not clearly identify patients with and without LSS, potentially because 3 out of 4 SSHQ questions refer to symptoms that overlap with other diagnostic categories. The STarT Back risk categories appear to be more informative in the diagnosis of LSS.