Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK.
Clin J Pain. 2013 Jul;29(7):644-54. doi: 10.1097/AJP.0b013e31826f9a52.
Low back pain (LBP) with leg pain, especially with findings of nerve root involvement, is considered as a poor prognostic indicator although it seems to have a favorable natural resolution. It is unclear whether patients with LBP and leg pain are at the more severe end of the spectrum as compared with patients with LBP alone or whether they are a distinct subgroup that would perhaps benefit from early identification of the condition and more targeted interventions. The purpose of this study was to investigate the impact of LBP-related leg pain on outcomes and use of health resources as compared with patients with LBP alone.
Systematic review of studies reporting separate outcomes of patients with LBP and LBP with leg pain and synthesis of available evidence. Literature search of all English language peer-reviewed publications was conducted using MEDLINE, EMBASE, and CINAHL for the years 1994 to 2010.
Of the papers retrieved, 9 were included in the review. The heterogeneity of studies allowed only narrative analysis of findings. All studies reported worse health outcomes and increased use of health care with radiation of leg pain distally and with neurological findings, with the exception of psychological outcomes.
LBP with pain radiating to the leg appears to be associated with increased pain, disability, poor quality of life, and increased use of health resources compared with LBP alone. These findings argue for early identification of these cases by health care professionals and pursuing effective treatments.
腰痛（LBP）伴腿部疼痛，特别是伴有神经根受累的表现，被认为是预后不良的指标，尽管它似乎有良好的自然缓解。尚不清楚腰痛伴腿部疼痛的患者是否比单纯腰痛患者处于更为严重的范围，或者他们是否是一个独特的亚组，可能受益于早期识别病情和更有针对性的干预。本研究旨在调查与单纯腰痛患者相比，LBP 相关腿部疼痛对结局和卫生资源利用的影响。
对报告腰痛和腰痛伴腿部疼痛患者的单独结局的研究进行系统评价，并对现有证据进行综合分析。使用 MEDLINE、EMBASE 和 CINAHL 对 1994 年至 2010 年的所有英语同行评审出版物进行文献检索。
检索到的论文中，有 9 篇被纳入综述。研究的异质性仅允许对研究结果进行叙述性分析。所有研究均报告腿部疼痛放射远处和出现神经学表现时健康结局更差，医疗保健利用增加，除了心理结局。
与单纯腰痛相比，腰痛伴腿部疼痛放射似乎与疼痛增加、残疾、生活质量下降以及卫生资源利用增加有关。这些发现表明，医疗保健专业人员应早期识别这些病例，并采用有效的治疗方法。
