Lorena S Reginato, Gustavo C Machado, Chris G Maher, Guilherme H D Grande, Ruben V C Vidal, Crystian B Oliveira
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引用次数: 0
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.
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.