急性背痛:临床和放射性诊断:WFNS脊柱委员会建议
Artem O Gushcha1, Salman Sharif2, Mehmet Zileli3
1Department of Neurosurgery, Research Center of Neurology, Moscow, Russia.
World neurosurgery: X
|February 23, 2024
概括
目前的指导方针建议不要为急性腰痛进行常规成像. 诊断应侧重于临床评估,为出现红旗症状的病例保留成像,以避免不必要的患者焦虑.
科学领域:
- 神经外科 神经外科
- 诊断成像 诊断成像 诊断成像
- 基于证据的医学基于证据的医学.
背景情况:
- 急性腰痛 (LBP) 影响了许多人,需要明确的诊断指南.
- 目前对急性腰痛的诊断实践不同,影响患者的治疗结果和医疗保健资源的利用.
研究的目的:
- 建立基于证据的建议,用于临床和放射性诊断急性腰痛 (持续时间<4周).
- 为管理急性LBP的医疗保健专业人员提供共识陈述.
主要方法:
- 在PubMed和谷歌学者 (2012-2022) 进行了系统的文献搜索.
- 世界神经外科协会 (WFNS) 脊柱委员会使用了德尔菲方法和两轮投票来产生共识声明.
- 分析了97篇论文,制定了10篇最终的共识声明.
主要成果:
- 十个共识陈述涵盖了急性LBP的临床诊断,区分原因,如光盘性,面部关节,关节和肌肌关节疼痛.
- 放射性诊断强调评估成像的必要性,时间和方式,建议不要常规使用,除非存在红旗迹象.
- 常规成像可能会通过揭示偶然发现,增加恐惧和焦虑,对患者产生负面影响.
结论:
- 支持推的证据质量通常不高.
- 需要进一步的研究来验证WFNS脊柱委员会对急性LBP诊断的建议.
- 临床评估至关重要,成像仅用于特定的适应症.
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