Prevalence of serious spinal pathologies and non-spinal conditions in low back pain: A systematic review and meta-analysis.

IF 3 3区 医学 Q1 ANESTHESIOLOGY
Pain Medicine Pub Date : 2025-06-24 DOI:10.1093/pm/pnaf078
Lorena S Reginato, Gustavo C Machado, Chris G Maher, Guilherme H D Grande, Ruben V C Vidal, Crystian B Oliveira
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Abstract

Objective: To estimate the prevalence of serious spinal pathologies and non-spinal conditions in people seeking care for LBP.

Methods: Literature searches were conducted in six electronic databases. Observational studies investigating the prevalence of serious spinal pathologies and non-spinal conditions in adults seeking healthcare for a complaint of LBP were considered eligible. Risk of bias was assessed using a tool for prevalence studies. Meta-analyses using random effect models were conducted to obtain pooled prevalence estimates.

Results: Eleven studies were included in this review; most (64%) at low risk of bias. Based on moderate certainty of evidence, the pooled prevalence of serious spinal pathologies was 2.9% (95% Confidence Interval: 1.6% to 5.2%) in people with a complaint of LBP at presentation. The prevalence however varied by setting: Primary care 0.8%, ED 2.1%, secondary care 4.6% and tertiary care 6.9%. Based on moderate certainty of evidence, the prevalence of individual serious spinal pathologies ranged from 0.3% for cauda equina syndrome to 2.4% for spinal fracture. The prevalence of non-spinal conditions from Australian ED studies varied greatly ranging from 21.5% to 58.3%.

Conclusion: The prevalence of serious spinal pathologies and non-spinal conditions varied greatly. Differential diagnostic strategies with clear care pathways need to be available to ensure a prompt diagnosis of serious spinal pathologies and non-spinal conditions.

腰痛中严重脊柱病变和非脊柱疾病的患病率:一项系统综述和荟萃分析。
目的:评估腰痛患者严重脊柱病变和非脊柱疾病的患病率。方法:在6个电子数据库中进行文献检索。调查因腰痛求医的成人严重脊柱病变和非脊柱疾病患病率的观察性研究被认为是合格的。使用流行病学研究工具评估偏倚风险。采用随机效应模型进行meta分析,以获得汇总的患病率估计值。结果:本综述纳入了11项研究;大多数(64%)偏倚风险低。基于中等确定性的证据,在主诉腰痛的患者中,严重脊柱病变的总患病率为2.9%(95%可信区间:1.6%至5.2%)。然而,患病率因环境而异:初级保健0.8%,ED 2.1%,二级保健4.6%,三级保健6.9%。基于中等确定性的证据,个体严重脊柱病变的患病率从马尾综合征的0.3%到脊柱骨折的2.4%不等。在澳大利亚ED研究中,非脊柱疾病的患病率差异很大,从21.5%到58.3%不等。结论:严重脊柱病变和非脊柱疾病的患病率差异很大。需要提供具有明确护理途径的鉴别诊断策略,以确保及时诊断严重脊柱病变和非脊柱疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pain Medicine
Pain Medicine 医学-医学:内科
CiteScore
6.50
自引率
3.20%
发文量
187
审稿时长
3 months
期刊介绍: Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.
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