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从普通科转诊来进行腰椎磁共振成像检查的患者中脊柱病变的患病率。

Prevalence of spinal pathology in patients presenting for lumbar MRI as referred from general practice.

作者信息

de Schepper Evelien I T, Koes Bart W, Veldhuizen Erik F H, Oei Edwin H G, Bierma-Zeinstra Sita M A, Luijsterburg Pim A J

机构信息

Department of General Practice, Erasmus MC, University Medical Center, Rotterdam,

Department of General Practice, Erasmus MC, University Medical Center, Rotterdam.

出版信息

Fam Pract. 2016 Feb;33(1):51-6. doi: 10.1093/fampra/cmv097. Epub 2015 Dec 8.

Abstract

BACKGROUND

The use of magnetic resonance imaging (MRI) as initial imaging for back pain has increased in general practice. However, few data are available on the characteristics of these referred patients. The objective of this study was to describe the baseline characteristics and MRI findings of patients presenting for a lumbar MRI examination as referred by their GP.

METHODS

Patients presenting for a lumbar MRI examination as referred by their GP were recruited at the MRI Center. The MRI radiology reports were scored for the presence of disc bulging, disc herniation, nerve root compression, spinal stenosis, spondylolisthesis and serious pathologies. Information on patients' characteristics, characteristics of the complaints and red flags were derived from questionnaires. Cross-sectional differences between patients with and without specific MRI findings were analyzed.

RESULTS

A total of 683 low back pain (LBP) patients were included; mean age was 49.9 (range 19-80) years and 53% was male. Mean back pain severity score was 6.6 (SD 2.0) and 67% of the patients reported having chronic LBP. In total, 374 patients (55%) reported sciatica complaints for at least 6 weeks. Of all MRI reports, 69% mentioned signs of nerve root compression. Serious pathologies were reported in 3% of the patients. In total, 94% of patients had abnormal MRI findings.

CONCLUSIONS

Almost all patients presenting for a lumbar MRI examination as referred by their GP had abnormal MRI findings. In total, 55% of the patients reported persistent sciatica in which imaging is recommended according to international guidelines.

摘要

背景

在全科医疗中,使用磁共振成像(MRI)作为背痛的初始影像学检查的情况有所增加。然而,关于这些转诊患者的特征,可用数据很少。本研究的目的是描述由全科医生转诊进行腰椎MRI检查的患者的基线特征和MRI检查结果。

方法

在MRI中心招募由全科医生转诊进行腰椎MRI检查的患者。对MRI放射学报告进行评分,以确定是否存在椎间盘膨出、椎间盘突出、神经根受压、椎管狭窄、椎体滑脱和严重病变。通过问卷调查获取患者特征、症状特征和警示信号的信息。分析有和没有特定MRI检查结果的患者之间的横断面差异。

结果

共纳入683例腰痛(LBP)患者;平均年龄为49.9岁(范围19 - 80岁),男性占53%。平均背痛严重程度评分为6.6(标准差2.0),67%的患者报告患有慢性腰痛。总共有374例患者(55%)报告坐骨神经痛症状至少持续6周。在所有MRI报告中,69%提到神经根受压迹象。3%的患者报告有严重病变。总共有94%的患者MRI检查结果异常。

结论

几乎所有由全科医生转诊进行腰椎MRI检查的患者MRI检查结果都异常。总共有55%的患者报告持续性坐骨神经痛,根据国际指南,这种情况建议进行影像学检查。

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