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使用腰椎成像来确定从事体力搬运的无症状工作者的工作适应性。

The use of lumbar spine imaging to determine fitness for work in asymptomatic workers who perform manual lifting.

作者信息

Myung Eduardo, Buarque Alexander

机构信息

Associação Paulista de Medicina do Trabalho, São Paulo, SR Brazil.

出版信息

Rev Bras Med Trab. 2024 Feb 16;21(4):e2021882. doi: 10.47626/1679-4435-2021-882. eCollection 2023 Oct-Dec.

DOI:10.47626/1679-4435-2021-882
PMID:39132277
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11316524/
Abstract

In occupational medicine, evidence-based practices are essential for assessing the accuracy, efficacy, and cost-effectiveness of any technologies used in health programs. This opinion article reflects on the use of imaging tests to screen for workers at risk of low back pain disability and to recommend avoiding tasks that involve high biomechanical risk. The limitations of such testing are discussed through basic epidemiological concepts and evidence collected from systematic reviews.

摘要

在职业医学中,循证实践对于评估健康项目中所使用的任何技术的准确性、有效性和成本效益至关重要。这篇观点文章探讨了利用影像检查来筛查有下背痛致残风险的工人,并建议避免从事涉及高生物力学风险的任务。通过基本的流行病学概念以及从系统评价中收集的证据,讨论了此类检查的局限性。

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本文引用的文献

1
Guideline adherence and lost workdays for acute low back pain in the California workers' compensation system.加州工人赔偿制度中急性下背痛的指南遵循情况和旷工天数。
PLoS One. 2021 Jun 17;16(6):e0253268. doi: 10.1371/journal.pone.0253268. eCollection 2021.
2
Overuse of diagnostic testing in healthcare: a systematic review.过度使用诊断检测在医疗保健中的应用:一项系统评价。
BMJ Qual Saf. 2022 Jan;31(1):54-63. doi: 10.1136/bmjqs-2020-012576. Epub 2021 May 10.
3
Current Evidence for Diagnosis of Common Conditions Causing Low Back Pain: Systematic Review and Standardized Terminology Recommendations.当前常见下腰痛病因诊断的证据:系统评价与标准化术语建议
J Manipulative Physiol Ther. 2019 Nov;42(9):651-664. doi: 10.1016/j.jmpt.2019.08.002. Epub 2019 Dec 20.
4
No consensus on causality of spine postures or physical exposure and low back pain: A systematic review of systematic reviews.脊柱姿势或身体暴露与下腰痛之间因果关系的共识:系统综述的系统综述。
J Biomech. 2020 Mar 26;102:109312. doi: 10.1016/j.jbiomech.2019.08.006. Epub 2019 Aug 13.
5
Impacts of Adherence to Evidence-Based Medicine Guidelines for the Management of Acute Low Back Pain on Costs of Worker's Compensation Claims.循证医学指南治疗急性腰痛对工人赔偿索赔费用的影响。
J Occup Environ Med. 2019 Jun;61(6):445-452. doi: 10.1097/JOM.0000000000001593.
6
Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work.影像学检查与不影像学检查对腰痛的影响:系统评价,测量成本、医疗保健利用和旷工情况。
Eur Spine J. 2019 May;28(5):937-950. doi: 10.1007/s00586-019-05918-1. Epub 2019 Feb 22.
7
Diagnostic accuracy of diagnostic imaging for lumbar disc herniation in adults with low back pain or sciatica is unknown; a systematic review.诊断成像对伴有腰痛或坐骨神经痛的成年腰椎间盘突出症的诊断准确性尚不清楚:一项系统评价。
Chiropr Man Therap. 2018 Aug 21;26:37. doi: 10.1186/s12998-018-0207-x. eCollection 2018.
8
Lumbar Spine X-Ray as a Standard Investigation for all Low back Pain in Ghana: Is It Evidence Based?腰椎X光作为加纳所有下背痛的标准检查手段:这有循证依据吗?
Ghana Med J. 2017 Mar;51(1):24-29. doi: 10.4314/gmj.v51i1.5.
9
Pre-employment examinations for preventing injury, disease and sick leave in workers.为预防工人受伤、患病和病假而进行的入职前检查。
Cochrane Database Syst Rev. 2016 Jan 12;2016(1):CD008881. doi: 10.1002/14651858.CD008881.pub2.
10
MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis.与无症状对照组相比,腰椎间盘退变的MRI表现在成人腰痛患者中更为普遍:一项系统评价和荟萃分析。
AJNR Am J Neuroradiol. 2015 Dec;36(12):2394-9. doi: 10.3174/ajnr.A4498. Epub 2015 Sep 10.