Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire ST5 5BG, UK.
BMC Musculoskelet Disord. 2012 Jan 20;13:4. doi: 10.1186/1471-2474-13-4.
Low-back related leg pain with or without nerve root involvement is associated with a poor prognosis compared to low back pain (LBP) alone. Compared to the literature investigating prognostic indicators of outcome for LBP, there is limited evidence on prognostic factors for low back-related leg pain including the group with nerve root pain. This 1 year prospective consultation-based observational cohort study will describe the clinical, imaging, demographic characteristics and health economic outcomes for the whole cohort, will investigate differences and identify prognostic indicators of outcome (i.e. change in disability at 12 months), for the whole cohort and, separately, for those classified with and without nerve root pain. In addition, nested qualitative studies will provide insights on the clinical consultation and the impact of diagnosis and treatment on patients' symptom management and illness trajectory.
Adults aged 18 years and over consulting their General Practitioner (GP) with LBP and radiating leg pain of any duration at (n = 500) GP practices in North Staffordshire and Stoke-on-Trent, UK will be invited to participate. All participants will receive a standardised assessment at the clinic by a study physiotherapist and will be classified according to the clinically determined presence or absence of nerve root pain/involvement. All will undergo a lumbar spine MRI scan. All participants will be managed according to their clinical need. The study outcomes will be measured at 4 and 12 months using postal self-complete questionnaires. Data will also be collected each month using brief postal questionnaires to enable detailed description of the course of low back and leg pain over time. Clinical observations and patient interviews will be used for the qualitative aspects of the study.
This prospective clinical observational cohort will combine self-reported data, comprehensive clinical and MRI assessment, together with qualitative enquiries, to describe the course, health care usage, patients' experiences and prognostic indicators in an adult population presenting in primary care with LBP and leg pain with or without nerve root involvement.
与单纯腰痛（LBP）相比，伴有或不伴有神经根受累的下腰痛相关下肢痛预后较差。与调查 LBP 结局预后指标的文献相比，关于包括神经根痛组在内的下腰痛相关下肢痛的预后因素的证据有限。这项为期 1 年的基于会诊的前瞻性观察队列研究将描述整个队列的临床、影像学、人口统计学特征和健康经济学结局，将调查整个队列以及无神经根痛和有神经根痛分组之间的差异，并确定结局的预后指标（即 12 个月时残疾程度的变化）。此外，嵌套的定性研究将提供对临床会诊的深入了解，以及诊断和治疗对患者症状管理和疾病轨迹的影响。
英国北斯塔福德郡和斯托克-on-Trent 的 500 家全科医生（GP）诊所将邀请年龄在 18 岁及以上、因腰痛和放射状下肢痛就诊（持续任何时间）的成年人参与。所有参与者将在诊所由研究物理治疗师进行标准化评估，并根据临床确定的是否存在神经根痛/受累进行分类。所有参与者都将接受腰椎 MRI 扫描。所有参与者将根据其临床需求进行管理。研究结果将在 4 个月和 12 个月使用邮寄自我完成问卷进行测量。还将每月通过简短的邮寄问卷收集数据，以详细描述随时间推移下腰痛和腿痛的病程。临床观察和患者访谈将用于研究的定性部分。
这项前瞻性临床观察队列研究将结合自我报告数据、全面的临床和 MRI 评估以及定性调查，描述在初级保健中因 LBP 和下肢痛就诊的成年人群中，伴有或不伴有神经根受累的下腰痛相关下肢痛的病程、医疗保健使用情况、患者体验和预后指标。
