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

Cost utility Diagnosis Evidence-based guideline Low back pain Lumbago Lumbar Lumbar pain Lumbosacral Prognosis Treatment

Journal

The spine journal : official journal of the North American Spine Society
ISSN: 1878-1632
Titre abrégé: Spine J
Pays: United States
ID NLM: 101130732

Informations de publication

Date de publication:
07 2020
Historique:
received: 06 04 2020
accepted: 13 04 2020
pubmed: 26 4 2020
medline: 1 7 2021
entrez: 26 4 2020
Statut: ppublish

Résumé

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. 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. This is a guideline summary review. This guideline is the product of the Low Back Pain Work Group of NASS' Evidence-Based 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. 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. 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.

Sections du résumé

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' Evidence-Based 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.

Identifiants

pubmed: 32333996
pii: S1529-9430(20)30141-8
doi: 10.1016/j.spinee.2020.04.006
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

998-1024

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

Auteurs

D Scott Kreiner (DS)

Barrow Neurological Institute, 4530 E. Muirwood Dr. Ste. 110, Phoenix, AZ 85048-7693, USA. Electronic address: scott.kreiner@barrowbrainandspine.com.

Paul Matz (P)

Advantage Orthopedics and Neurosurgery, Casper, WY, USA.

Christopher M Bono (CM)

Massachusetts General Hospital, Boston, MA, USA.

Charles H Cho (CH)

Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

John E Easa (JE)

Michigan State University, Holland, MI, USA.

Gary Ghiselli (G)

Denver Spine Surgeons, Greenwood Village, CO, USA.

Zoher Ghogawala (Z)

Lahey Hospital and Medical Center, Burlington, MA, USA; Tufts University School of Medicine, Boston, MA, USA.

Charles A Reitman (CA)

Medical University of South Carolina, Charleston, SC, USA.

Daniel K Resnick (DK)

University of Wisconsin, Madison, WI, USA.

William C Watters (WC)

Institute of Academic Medicine Houston Methodist Hospital, Houston, TX, USA.

Thiru M Annaswamy (TM)

VA North Texas Health Care System, UT Southwestern Medical Center, Dallas, TX, USA.

Jamie Baisden (J)

Medical College of Wisconsin, Milwaukee, WI, USA.

Walter S Bartynski (WS)

Duke University, Durham, NC, USA.

Shay Bess (S)

Denver International Spine Center, Denver, CO, USA.

Randall P Brewer (RP)

River Cities Interventional Pain Specialists, Shreveport, LA, USA.

R Carter Cassidy (RC)

University of Kentucky College of Medicine, Lexington, KY, USA.

David S Cheng (DS)

University of Southern California, Los Angeles, CA, USA.

Sean D Christie (SD)

QE II Health Sciences Centre, Halifax NS B3H 3A7, Canada.

Norman B Chutkan (NB)

The CORE Institute, Phoenix, AZ, USA.

Bernard Allan Cohen (BA)

Neurological Monitoring Associates, LLC, Milwaukee, WI, USA.

Simon Dagenais (S)

Spine Research LLC, Winchester, MA, USA.

Dennis E Enix (DE)

Ballwin, Missouri.

Paul Dougherty (P)

VA Finger Lakes Healthcare System, Canandaigua, NY, USA.

S Raymond Golish (SR)

Jupiter Medical Center, Jupiter, FL, USA.

Padma Gulur (P)

Duke University, Durham, NC, USA.

Steven W Hwang (SW)

Shriners Hospital for Children, Philadelphia, PA, USA.

Cumhur Kilincer (C)

Trakya University Faculty of Medicine, Edirne, Turkey.

Jeffrey A King (JA)

Medical College of Wisconsin, Milwaukee, WI, USA.

Adam C Lipson (AC)

IGEA Brain & Spine, Union, NJ, USA.

Anthony J Lisi (AJ)

VACT Healthcare System, West Haven, CT, USA.

Richard J Meagher (RJ)

Princeton Brain, Spine & Sports Medicine, Mullica Hill, NJ, USA.

John E O'Toole (JE)

Rush University, Chicago, IL, USA.

Paul Park (P)

University Of Michigan, Ann Arbor, MI, USA.

Murat Pekmezci (M)

University of California, San Francisco, CA, USA.

Daniel R Perry (DR)

Choice Physical Therapy, Christiansburg, VA, USA.

Ravi Prasad (R)

University of California, Davis, Sacramento, CA, USA.

David A Provenzano (DA)

Pain Diagnostics and Interventional Care, Sewickley, PA, USA.

Kris E Radcliff (KE)

Rothman Institute, Thomas Jefferson University, Egg Harbor Township, NJ, USA.

Gazanfar Rahmathulla (G)

University of Florida College of Medicine, Jacksonville, FL, USA.

Tom E Reinsel (TE)

Huntington, WV, USA.

Robert L Rich (RL)

Bladen Medical Associates, Elizabethtown, NC, USA.

Daniel S Robbins (DS)

Synergy Surgicalists, Portland, ME, USA.

Karie A Rosolowski (KA)

North American Spine Society, Burr Ridge, IL, USA.

Jonathan N Sembrano (JN)

University of Minnesota, Minneapolis, MN, USA.

Anil K Sharma (AK)

Spine and Pain Centers, Wall, NJ, USA.

Alison A Stout (AA)

Evergreen Sport and Spine Center, Kirkland, WA, USA.

Christopher K Taleghani (CK)

Maui Brain and Spine, Wailuku, HI, USA.

Ryan A Tauzell (RA)

Choice Physical Therapy & Wellness, Christiansburg, VA, USA.

Terry Trammell (T)

Trammell Consulting LLC, Pittsboro, IN, USA.

Yakov Vorobeychik (Y)

Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

Amy M Yahiro (AM)

North American Spine Society, Burr Ridge, IL, USA.

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Classifications MeSH