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近期新发腰痛或腰椎神经根病患者非手术治疗的国家临床指南。

National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy.

作者信息

Stochkendahl Mette Jensen, Kjaer Per, Hartvigsen Jan, Kongsted Alice, Aaboe Jens, Andersen Margrethe, Andersen Mikkel Ø, Fournier Gilles, Højgaard Betina, Jensen Martin Bach, Jensen Lone Donbæk, Karbo Ture, Kirkeskov Lilli, Melbye Martin, Morsel-Carlsen Lone, Nordsteen Jan, Palsson Thorvaldur Skuli, Rasti Zoreh, Silbye Peter Frost, Steiness Morten Zebitz, Tarp Simon, Vaagholt Morten

机构信息

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.

Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.

出版信息

Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20.

Abstract

PURPOSE

To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority.

METHODS

Two multidisciplinary working groups formulated recommendations based on the GRADE approach.

RESULTS

Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active. If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids.

CONCLUSION

Recommendations are based on low to moderate quality evidence or on consensus, but are well aligned with recommendations from international guidelines. The guideline working groups recommend that research efforts in relation to all aspects of management of LBP and LR be intensified.

摘要

目的

基于丹麦卫生当局的两项指南,总结关于近期发作(<12周)非特异性腰痛(LBP)和腰椎神经根病(LR)的20种非手术干预措施的建议。

方法

两个多学科工作组基于GRADE方法制定建议。

结果

16项建议基于证据,4项基于共识。LBP和LR的管理应包括关于预后、警示信号的信息,并建议保持活动。如果需要治疗,指南建议采用患者教育、不同类型的监督锻炼和手法治疗。指南不建议使用针灸、常规影像学检查、靶向治疗、椎间孔外糖皮质激素注射、对乙酰氨基酚、非甾体抗炎药和阿片类药物。

结论

建议基于低至中等质量的证据或共识,但与国际指南的建议高度一致。指南工作组建议加强与LBP和LR管理各方面相关的研究工作。

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