Alharbi Ahmad H, AlSindi Tala, Ashoor Albaraa F, Almalki Abdulrahman M, Aljabri Mansour I, Almaghrabi Murouj, Alothman Ahmed M, Almaghrabi Nizar A, Boubaker Adnan M
Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, SAU.
Department of Neurosurgery, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU.
Cureus. 2023 Sep 18;15(9):e45463. doi: 10.7759/cureus.45463. eCollection 2023 Sep.
Background Low back pain (LBP) is common and considerably impacts daily lives across all age groups. MRI is not frequently used as a first-line investigation for patients presenting with LBP, except in the presence of red-flag symptoms. This study aimed to use pain severity and its impact as a predictor for MRI findings to help physicians decide whether a patient needs an MRI. Methods This cross-sectional study was conducted at the outpatient clinic of the neurosurgery department. The questionnaire included demographic data of the patients, red-flag symptoms, and the Dallas Pain Questionnaire (DPQ). The primary physician then determines whether the patient should have an MRI appointment. Results The study included 100 patients with LBP, of which 71 had chronic LBP (CLBP). Out of these 71, an MRI was requested for 62, but only 26 had findings related to LBP. Regarding the impact of CLBP on daily activities as measured by the DPQ, there was a significant association between those whose CLBP affected their daily activities and the decision to request an MRI. However, no significant statistical association was found between the three other parameters of the DPQ and the primary physician's decision to request an MRI. Conclusion Concerning the use of the DPQ questionnaire to predict MRI findings in patients with CLBP, the study indicates that significant pain impact on the DPQ does not necessarily correlate with MRI findings related to LBP. This suggests that the DPQ evaluation tool has no advantage over a physician's clinical judgment.
背景 腰痛(LBP)很常见,对所有年龄组的日常生活都有相当大的影响。除了存在警示症状外,MRI并不常用于腰痛患者的一线检查。本研究旨在将疼痛严重程度及其影响作为MRI检查结果的预测指标,以帮助医生决定患者是否需要进行MRI检查。方法 这项横断面研究在神经外科门诊进行。问卷包括患者的人口统计学数据、警示症状和达拉斯疼痛问卷(DPQ)。然后由主治医生决定患者是否应预约MRI检查。结果 该研究纳入了100例腰痛患者,其中71例为慢性腰痛(CLBP)。在这71例患者中,62例被要求进行MRI检查,但只有26例有与腰痛相关的检查结果。关于通过DPQ测量的CLBP对日常活动的影响,CLBP影响其日常活动的患者与要求进行MRI检查的决定之间存在显著关联。然而,在DPQ的其他三个参数与主治医生要求进行MRI检查的决定之间未发现显著的统计学关联。结论 关于使用DPQ问卷预测CLBP患者的MRI检查结果,该研究表明,DPQ上显著的疼痛影响不一定与与LBP相关的MRI检查结果相关。这表明DPQ评估工具并不比医生的临床判断更具优势。