Spine radiography in the evaluation of back and neck pain in an orthopaedic emergency clinic

Leichtle, Ulf Gunther; Wünschel, Markus; Socci, Marianna; Kurze, Christophe; Niemeyer, Thomas; Leichtle, Carmen Ina (2015). Spine radiography in the evaluation of back and neck pain in an orthopaedic emergency clinic. Journal of back and musculoskeletal rehabilitation, 28(1), pp. 43-48. IOS Press 10.3233/BMR-140488

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BACKGROUND AND OBJECTIVES

Despite the recommendations of national and international societies for the treatment of patients with acute neck and back pain, still too many radiologic examinations were performed. The purpose of this study was to analyze and optimize diagnostics and treatment of patients with acute back pain.

METHODS

The medical records of 484 patients presented to the emergency clinic with acute neck or back pain were analyzed for clinical history, physical examination, radiographic findings and therapy.

RESULTS

Radiographs of the lumbar, cervical, or thoracic spine were performed in 338 cases (70%). Radiographs were normal in 142 patients (42%) and degenerative changes were identified in 123 patients (36%). Only 2 patients (0.4%) had radiographic findings that had direct therapeutic relevance: 1 patient with metastatic disease and 1 patient with posttraumatic C1-C2 instability. For most patients without sensorimotor deficits and absent specific indications for radiography (“red flags”), therapy was not affected by the results of radiography.

CONCLUSIONS

Plain radiography of the spine was unnecessary in most patients initially evaluated with non-specific acute back pain and does not improve the clinical outcome. The implementation of national and international guidelines is a slow process, but helps to reduce costs and to protect patients from unnecessary ionizing radiation exposure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Kurze, Christophe

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1053-8127, 1878-6324

Publisher:

IOS Press

Language:

English

Submitter:

Fabian Röthlisberger

Date Deposited:

29 Mar 2016 16:26

Last Modified:

05 Dec 2022 14:52

Publisher DOI:

10.3233/BMR-140488

PubMed ID:

24968795

URI:

https://boris.unibe.ch/id/eprint/77291

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