Combining clinical exams can better predict lumbar spine radiographic instability

Review written by Dr Michael Reiman info

Key Points

  1. None of the five clinical tests established significant diagnostic accuracy in patients with chronic low back pain.
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BACKGROUND & OBJECTIVE

Low back spine instability has a prevalence of up to 57% in chronic low back pain (LBP) (1) and can be a significant cause of pain and disability (2), as well as recurrence (2,3).

The primary objective of this cross-sectional diagnostic study was to evaluate the accuracy of several lumbar instability exams whose diagnostic accuracy has not been evaluated or has not yet been conclusively determined. A secondary goal was to examine the diagnostic accuracy of a combination of specific historical and demographic variables with clinical instability exams to predict lumbar instability.

Low back spine instability has a prevalence of up to 57% in chronic low back pain.
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The diagnosis of lumbar segmental instability is challenging due to the lack of a proper gold standard.

METHODS

  • A cross-sectional diagnostic study following standards for reporting of diagnostic accuracy (STARD) guidelines.
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