Guideline summary review: an evidence -based clinical guideline for the diagnosis and treatment of low back pain

被引：249

作者：

Kreiner, D. Scott ^{[1
]}

Matz, Paul ^{[2
]}

Bono, Christopher M. ^{[3
]}

Cho, Charles H. ^{[4
]}

Easa, John E. ^{[5
]}

Ghiselli, Gary ^{[6
]}

Ghogawala, Zoher ^{[7
,8
]}

Reitman, Charles A. ^{[9
]}

Resnick, Daniel K. ^{[10
]}

Watters, William C., III ^{[11
]}

Annaswamy, Thiru M. ^{[12
]}

Baisden, Jamie ^{[13
]}

Bartynski, Walter S. ^{[14
]}

Bess, Shay ^{[15
]}

Brewer, Randall P. ^{[16
]}

Cassidy, R. Carter ^{[17
]}

Cheng, David S. ^{[18
]}

Christie, Sean D. ^{[19
]}

Chutkan, Norman B. ^{[20
]}

Cohen, Bernard Allan ^{[21
]}

Dagenais, Simon ^{[22
]}

Enix, Dennis E.

Dougherty, Paul ^{[23
]}

Golish, S. Raymond ^{[24
]}

Gulur, Padma ^{[14
]}

Hwang, Steven W. ^{[25
]}

Kilincer, Cumhur ^{[26
]}

King, Jeffrey A. ^{[13
]}

Lipson, Adam C. ^{[27
]}

Lisi, Anthony J. ^{[28
]}

Meagher, Richard J. ^{[29
]}

O'Toole, John E. ^{[30
]}

Park, Paul ^{[31
]}

Pekmezci, Murat ^{[32
]}

Perry, Daniel R. ^{[33
]}

Prasad, Ravi ^{[34
]}

Provenzano, David A. ^{[35
]}

Radcliff, Kris E. ^{[36
]}

Rahmathulla, Gazanfar ^{[37
]}

Reinsel, Tom E.

Rich, Robert L., Jr. ^{[38
]}

Robbins, Daniel S. ^{[39
]}

Rosolowski, Karie A. ^{[40
]}

Sembrano, Jonathan N. ^{[41
]}

Sharma, Anil K. ^{[42
]}

Stout, Alison A. ^{[43
]}

Taleghani, Christopher K. ^{[44
]}

Tauzell, Ryan A. ^{[45
]}

Trammell, Terry ^{[46
]}

Vorobeychik, Yakov ^{[47
]}

机构：

[1] Barrow Neurol Inst, 4530 E Muirwood Dr Ste 110, Phoenix, AZ 85048 USA

[2] Adv Orthoped & Neurosurg, Casper, WY USA

[3] Massachusetts Gen Hosp, Boston, MA 02114 USA

[4] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA 02115 USA

[5] Michigan State Univ, Holland, MI USA

[6] Denver Spine Surg, Greenwood Village, CO USA

[7] Lahey Hosp & Med Ctr, Burlington, MA USA

[8] Tufts Univ, Sch Med, Boston, MA 02111 USA

[9] Med Univ South Carolina, Charleston, SC 29425 USA

[10] Univ Wisconsin, Madison, WI USA

[11] Houston Methodist Hosp, Inst Acad Med, Houston, TX 77030 USA

[12] UT Southwestern Med Ctr, VA North Texas Hlth Care Syst, Dallas, TX USA

[13] Med Coll Wisconsin, Milwaukee, WI 53226 USA

[14] Duke Univ, Durham, NC USA

[15] Denver Int Spine Ctr, Denver, CO USA

[16] River Cities Intervent Pain Specialists, Shreveport, LA USA

[17] Univ Kentucky, Coll Med, Lexington, KY USA

[18] Univ Southern Calif, Los Angeles, CA 90007 USA

[19] QE II Hlth Sci Ctr, Halifax, NS B3H 3A7, Canada

[20] CORE Inst, Phoenix, AZ USA

[21] Neurol Monitoring Associates LLC, Milwaukee, WI USA

[22] Spine Res LLC, Winchester, MA USA

[23] VA Finger Lakes Healthcare Syst, Canandaigua, NY USA

[24] Jupiter Med Ctr, Jupiter, FL USA

[25] Shriners Hosp Children, Philadelphia, PA USA

[26] Trakya Univ, Fac Med, Edirne, Turkey

[27] IGEA Brain & Spine, Union, NJ USA

[28] VACT Healthcare Syst, West Haven, CT USA

[29] Princeton Brain Spine & Sports Med, Mullica Hill, NJ USA

[30] Rush Univ, Chicago, IL 60612 USA

[31] Univ Michigan, Ann Arbor, MI 48109 USA

[32] Univ Calif San Francisco, San Francisco, CA 94143 USA

[33] Choice Phys Therapy, Christiansburg, VA USA

[34] Univ Calif Davis, Sacramento, CA 95817 USA

[35] Pain Diagnost & Intervent Care, Sewickley, PA USA

[36] Thomas Jefferson Univ, Rothman Inst, Egg Harbor Township, NJ USA

[37] Univ Florida, Coll Med, Jacksonville, FL USA

[38] Bladen Med Associates, Elizabethtown, NC USA

[39] Synergy Surgicalists, Portland, ME USA

[40] North Amer Spine Soc, Burr Ridge, IL USA

[41] Univ Minnesota, Minneapolis, MN USA

[42] Spine & Pain Ctr, Wall, NJ USA

[43] Evergreen Sport & Spine Ctr, Kirkland, WA USA

[44] Maui Brain & Spine, Wailuku, HI USA

[45] Choice Phys Therapy & Wellness, Christiansburg, VA USA

[46] Trammell Consulting LLC, Pittsboro, IN USA

[47] Penn State Hlth Milton S Hershey Med Ctr, Hershey, PA USA

[48] North Amer Spine Soc, Burr Ridge, IL USA

来源：

SPINE JOURNAL | 2020年 / 20卷 / 07期

关键词：

Cost utility; Diagnosis; Evidence-based guideline; Low back pain; Lumbago; Lumbar; Lumbar pain; Lumbosa-; cral; Prognosis; Treatment; RANDOMIZED-CONTROLLED-TRIAL; QUALITY-OF-LIFE; ELECTRICAL NERVE-STIMULATION; SPINAL MANIPULATIVE THERAPY; LEVEL HEATWRAP THERAPY; TRAMADOL/ACETAMINOPHEN COMBINATION TABLETS; FUNCTIONAL RESTORATION PROGRAM; COGNITIVE-BEHAVIORAL THERAPY; INTENSITY AEROBIC EXERCISE; CORE STABILITY EXERCISES;

D O I：

10.1016/j.spinee.2020.04.006

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

BACKGROUND CONTEXT: The North American Spine Society's (NASS) Evidence Based Clinical Guideline for the Diagnosis and Treatment of Low Back Pain features evidence-based recommendations for diagnosing and treating adult patients with nonspecific low back pain. The guideline is intended to reflect contemporary treatment concepts for nonspecific low back pain as reflected in the highest quality clinical literature available on this subject as of February 2016. PURPOSE: The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with nonspecific low back pain. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition. STUDY DESIGN: This is a guideline summary review. METHODS: This guideline is the product of the Low Back Pain Work Group of NASS' EvidenceBased Clinical Guideline Development Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questions to address in the guideline. The literature search strategy was developed in consultation with medical librarians. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in webcasts and in-person recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guideline was submitted to an internal and external peer review process and ultimately approved by the NASS Board of Directors. RESULTS: Eighty-two clinical questions were addressed, and the answers are summarized in this article. The respective recommendations were graded according to the levels of evidence of the supporting literature. CONCLUSIONS: The evidence-based clinical guideline has been created using techniques of evidence-based medicine and best available evidence to aid practitioners in the diagnosis and treatment of adult patients with nonspecific low back pain. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flowchart, suggestions for future research, and all of the references, is available electronically on the NASS website at https://www. spine.org/ResearchClinicalCare/QualityImprovement/ClinicalGuidelines.aspx (c) 2020 Published by Elsevier Inc.

引用

页码：998 / 1024

页数：27

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