Schellingerhout Jasper M
Het Huisartsenteam De Keen, Etten-Leur, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(32):A6592.
The practice guideline 'Invasive treatment of spine related low back pain' was recently released by the Netherlands Society of Anesthesiologists. This guideline evaluates the state of the art regarding the diagnosis and value of invasive treatment for facet joint pain, pain in the sacroiliac joint, coccygodynia, discogenic pain and the 'failed back surgery syndrome'. A new classification system for chronic low back pain was also proposed. The guideline was created in a methodologically sound manner, but the results are disappointing: the evaluated diagnoses remain disputable and the recommendations for the evaluated treatments are mostly based on expert opinion. The guideline lacks information on the scientific basis of the proposed new classification system, which makes its clinical usefulness questionable.
荷兰麻醉医师协会最近发布了实践指南《脊柱相关性下腰痛的侵入性治疗》。该指南评估了关于小关节疼痛、骶髂关节疼痛、尾骨痛、椎间盘源性疼痛和“腰椎手术失败综合征”的侵入性治疗的诊断现状及价值。还提出了一种慢性下腰痛的新分类系统。该指南的制定方法合理,但结果令人失望:所评估的诊断仍存在争议,且针对所评估治疗的建议大多基于专家意见。该指南缺乏关于所提出新分类系统科学依据的信息,这使得其临床实用性存疑。