Gay Ralph E, Brault Jeffrey S
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
Spine J. 2008 Jan-Feb;8(1):234-42. doi: 10.1016/j.spinee.2007.10.025.
The management of chronic low back pain (CLBP) has proven to be very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient. To help understand and evaluate the various commonly used nonsurgical approaches to CLBP, the North American Spine Society has sponsored this special focus issue of The Spine Journal, titled Evidence-Informed Management of Chronic Low Back Pain Without Surgery. Articles in this special focus issue were contributed by leading spine practitioners and researchers, who were invited to summarize the best available evidence for a particular intervention and encouraged to make this information accessible to nonexperts. Each of the articles contains five sections (description, theory, evidence of efficacy, harms, and summary) with common subheadings to facilitate comparison across the 24 different interventions profiled in this special focus issue, blending narrative and systematic review methodology as deemed appropriate by the authors. It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP.
慢性下腰痛（CLBP）的管理在北美已被证明极具挑战性，其日益加重的社会经济负担就是明证。对于包括患者、医疗服务提供者、政策制定者和第三方支付者在内的许多利益相关者而言，在现有的非手术疗法中做出选择可能会让人应接不暇。尽管各方都有一个共同目标，即希望利用有限的医疗资源来支持最有可能带来具有临床意义改善的干预措施，但对于特定患者而言，最恰当的干预措施往往存在不确定性。为了帮助理解和评估各种常用的CLBP非手术治疗方法，北美脊柱协会赞助了《脊柱杂志》的这一特别关注专题，题为《非手术治疗慢性下腰痛的循证管理》。本特别关注专题中的文章由脊柱领域的顶尖从业者和研究人员撰写，他们受邀总结特定干预措施的最佳现有证据，并鼓励将这些信息提供给非专业人士。每篇文章都包含五个部分（描述、理论、疗效证据、危害和总结），并有通用的副标题，以便于对本特别关注专题中介绍的24种不同干预措施进行比较，作者会根据情况将叙述性和系统评价方法相结合。希望本特别关注专题中的文章能提供有用信息，并有助于众多评估CLBP非手术干预措施的利益相关者做出决策。
