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Lumbar Spinal Stenosis (LSS) Care Pathway

Date of last update: November, 2024

Development and Evidence Selection

The pathway integrates guidance from guidelines evaluated through the AGREE II tool, systematic reviews assessed with AMSTAR, clinical textbooks, and curricula from accredited institutions.

  • Guideline and evidence selection: Treatment recommendations are based on broad literature searches to capture current guidelines. High-quality systematic reviews were used when guidelines were unavailable.

  • Consistent recommendations: Treatments reflect consistent recommendations across multiple guidelines and systematic reviews, demonstrating evidence of benefit or harm.

  • Inconsistent or unsupported recommendations: Conflicting or evolving recommendations are addressed in these notes to focus on well-supported, evidence-driven practice.

  • Knowledge user input: Input from clinical leaders, educators, and researchers, ensures practical alignment with current evidence.

  • Updates: This pathway is updated to reflect evolving evidence, with changes communicated through social media and other channels.

Search Strategy Overview

  • Primary sources: PubMed/MEDLINE, Google Scholar, Guidelines International Network (GIN), and NICE guidelines were used to identify relevant guidelines and reviews.

  • Timeframe: Searches are limited to guidelines and reviews published within the last 10- 15 years to ensure recommendations reflect the most recent and clinically relevant evidence.

  • Search terms: Tailored to each care pathway topic, combining relevant conditions (e.g., "low back pain", "shoulder pain") with terms such as "guideline" or "systematic review".

  • Search limits: Only the top results were reviewed in each database to focus on relevant sources (e.g., first 50-100 results).

  • Manual additions: Contributions from knowledge user networks to ensure inclusion of important guidelines.

  • Documentation: Search terms, sources, and critical appraisals are documented for transparency.

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CCGI is funded by provincial associations and regulatory boards, and national associations including the Canadian Chiropractic Association

and Canadian Chiropractic Protective Association. CCGI maintains editorial independence from funders.

All content and media on the Canadian Chiropractic Guideline Initiative (CCGI) website is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of a qualified health professional with questions, concerns or management regarding your health.

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