An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy |
| |
| Authors: | D Scott Kreiner Steven W Hwang John E Easa Daniel K Resnick Jamie L Baisden Shay Bess Charles H Cho Michael J DePalma Paul Dougherty Robert Fernand Gary Ghiselli Amgad S Hanna Tim Lamer Anthony J Lisi Daniel J Mazanec Richard J Meagher Robert C Nucci Rakesh D Patel John F Toton |
| |
| Institution: | 1. Ahwatukee Sports and Spine, 4530 E. Muirwood Dr, Suite 110, Phoenix, AZ 85048-7693, USA;2. Department of Neurosurgery, Tufts Medical Center, 800 Washington St, Boston, MA 02111-1552, USA;3. The College of Human Medicine, Michigan State University, 12662 Riley St, Suite 120, Holland, MI 49424-8023, USA;4. Department Neurosurgery, University of Wisconsin Medical School, K4/834 Clinical Science Center, 600 Highland, Madison, WI 53792-0001, USA;5. Department of Neurosurgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI 53226-3522, USA;6. Rocky Mountain Scoliosis and Spine, 2055 High St, Suite 130, Denver, CO 80205-5504, USA;7. Brigham and Women''s Hospital, 75 Francis St, Boston, MA 02115-6110, USA;8. 2918 Calcutt Drive, Midlothian, VA 23113-2681, USA;9. 2000 Van Auken Rd, Newark, NY 14513-9221, USA;10. 160 Cheyenne Way, Wayne, NJ 07470-4907, USA;11. Denver Spine, 7800 E. Orchard Rd, Suite 100, Greenwood Village, CO 80111-2584, USA;12. 9120 Bear Claw Way, Madison, WI 53717-2734, USA;13. Mayo Clinic Rochester, 200 1st St SW, Eisenberg 8G, Rochester, MN 55905-0001, USA;14. VACT Healthcare System, 950 Campbell Ave., Bldg 2, Floor 4, West Haven, CT 06516-2770, USA;15. Cleveland Clinic Spine Institute, 9500 Euclid Ave., C21, Cleveland, OH 44195-0001, USA;p. 2152 Susquehanna Rd, Abington, PA 19001-4408, USA;q. 6322 Gunn Hwy, Tampa, FL 33625-4105, USA;r. University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5000, USA;s. University of Minnesota, 2450 Riverside Ave. S., Suite R200, Minneapolis, MN 55454-1450, USA;t. Spine and Pain Medicine, 2 Mockingbird Drive, Colts Neck, NJ 07722-2228, USA;u. NewSouth NeuroSpine, 2470 Flowood Drive, Flowood, MS 39232-9019, USA;v. Cumberland Brain and Spine, 3901 Central Pike, Suite 455, Hermitage, TN 37076-3490, USA;w. 3413 Mount Ariane Drive, San Diego, CA 92111-3910, USA;x. 4866 Hoen Ave., Santa Rosa, CA 95405-7452, USA;1. Department of Orthopaedic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan;2. Department of Surgical Nursing, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan;1. Orthopaedic Department of Peking University Third Hospital, No 49. North Garden Rd, HaiDian District, Beijing 100191, China;2. Pathology Department of Peking University Health Science Center, No 38. Xue Yuan Rd, HaiDian District, Beijing, 100191, China;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama City, Toyama 930-0194, Japan;2. Department of Orthopaedic Surgery, Toyama Rosai Hospital, 992 Rokuroumaru, Uozu City, Toyama 937-0042, Japan;1. Department of Orthopaedic Surgery, The Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuan Xi Rd, Wenzhou, Zhejing 325027, China;2. Radiology Department, The Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuan Xi Rd, Wenzhou, Zhejing 325027, China;3. Institute of Digitized Medicine, Wenzhou Medical College, Wenzhou University Town, Wenzhou, Zhejing 325035, China;1. Department of Orthopedic Surgery, Centre Hospitalier Universitaire Vaudois, Avenue Pierre Decker 4, 1011 Lausanne, Switzerland;2. Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Avenue du Bugnon 46, 1011 Lausanne, Switzerland |
| |
| Abstract: | Background contextThe objective of the North American Spine Society's (NASS) Evidence-Based Clinical Guideline for the Diagnosis and Treatment of Lumbar Disc Herniation with Radiculopathy is to provide evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of lumbar disc herniation with radiculopathy. The guideline is intended to reflect contemporary treatment concepts for symptomatic lumbar disc herniation with radiculopathy as reflected in the highest quality clinical literature available on this subject as of July 2011. The goals of the guideline recommendations are to assist in delivering optimum efficacious treatment and functional recovery from this spinal disorder.PurposeTo provide an evidence-based educational tool to assist spine specialists in the diagnosis and treatment of lumbar disc herniation with radiculopathy.Study designSystematic review and evidence-based clinical guideline.MethodsThis guideline is a product of the Lumbar Disc Herniation with Radiculopathy Work Group of NASS' Evidence-Based Guideline Development Committee. The work group consisted of multidisciplinary spine care specialists trained in the principles of evidence-based analysis. A literature search addressing each question and using a specific search protocol was performed on English-language references found in Medline, Embase (Drugs and Pharmacology), and four additional evidence-based databases to identify articles. The relevant literature was then independently rated using the NASS-adopted standardized levels of evidence. An evidentiary table was created for each of the questions. Final recommendations to answer each clinical question were developed via work group discussion, and grades were assigned to the recommendations using standardized grades of recommendation. In the absence of Level I to IV evidence, work group consensus statements have been developed using a modified nominal group technique, and these statements are clearly identified as such in the guideline.ResultsTwenty-nine clinical questions were formulated and addressed, and the answers are summarized in this article. The respective recommendations were graded by strength of the supporting literature, which was stratified by levels of evidence.ConclusionsThe clinical guideline has been created using the techniques of evidence-based medicine and best available evidence to aid practitioners in the care of patients with symptomatic lumbar disc herniation with radiculopathy. The entire guideline document, including the evidentiary tables, suggestions for future research, and all the references, is available electronically on the NASS Web site at http://www.spine.org/Pages/PracticePolicy/ClinicalCare/ClinicalGuidlines/Default.aspx and will remain updated on a timely schedule. |
| |
| Keywords: | Lumbar disc herniation Radiculopathy Guideline |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
