Acute back pain – Role of injection techniques and surgery: WFNS spine committee recommendationsWFNS spine committee recommendations

Autor: Nikolay Peev, Corinna Zygourakis, Christoph Sippl, G. Grasso, Joachim Oertel, Salman Sharif
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: World Neurosurgery: X, Vol 22, Iss , Pp 100315- (2024)
Druh dokumentu: article
ISSN: 2590-1397
DOI: 10.1016/j.wnsx.2024.100315
Popis: Objective: Lower back pain is a significant cause of morbidity, and despite a range of interventions available, there is a lack of consensus on the most efficacious treatments. The aim of this systematic review is to formulate a list of recommendations for the role of spinal injections and surgery in the treatment of acute back pain. Methods: A systematic literature search from 2012 to 2022 was conducted on Pubmed, Medline, and Cochrane Central Register of Controlled Trials for papers focusing on the role of injections and surgery for the management of acute lower back pain. Inclusion criteria included randomised controlled trials, as well as prospective and retrospective studies reporting primary outcomes (pain improvement (VAS score) and back-specific functional status) and secondary outcomes (post-procedure complications). These data were reviewed, presented, and voted on by an expert panel consisting of 14 attending spine surgeons from 14 countries at the consensus meeting of the World Federation of Neurosurgical Societies (WFNS) Spine Committee. A two-round consensus-based Delphi method was used to generate consensus, and topics with >66% agreement were categorized as having reached consensus. Results: 100 studies met inclusion criteria. Of these, 20 were selected by the committee for full text review and presented at the consensus meeting. The committee voted on 8 statements and achieved consensus on the following 7 statements: (1) Epidural steroid injections (ESIs) show significant benefit to discogenic back pain; (2) A lateral approach is superior to a midline approach for ESIs; (3) Short-term (
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