Pain medicine (Malden, Mass.) · 2026
Prevalence of serious spinal pathologies and nonspinal conditions in low back pain: a systematic review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Reginato Lorena S, Machado Gustavo C, Maher Chris G, Grande Guilherme H D, Vidal Ruben V C, Oliveira Crystian B
Аннотация
OBJECTIVE: To estimate the prevalence of serious spinal pathologies and nonspinal conditions in people seeking care for low back pain.
METHODS: Literature searches were conducted in 6 electronic databases. Observational studies investigating the prevalence of serious spinal pathologies and nonspinal conditions in adults seeking health care for a complaint of low back pain were considered eligible. Risk of bias was assessed with a tool for prevalence studies. Meta-analyses using random effect models were conducted to obtain pooled prevalence estimates.
RESULTS: Eleven studies were included in this review; most (64%) were at low risk of bias. With moderate certainty of evidence, the pooled prevalence of serious spinal pathologies was 2.9% (95% confidence interval: 1.6% to 5.2%) in people with a complaint of low back pain at presentation. The prevalence, however, varied by setting: primary care, 0.8%; emergency department, 2.1%; secondary care, 4.6%; and tertiary care, 6.9%. With moderate certainty of evidence, the prevalence of individual serious spinal pathologies ranged from 0.3% for cauda equina syndrome to 2.4% for spinal fracture. The prevalence of nonspinal conditions from Australian emergency department studies varied greatly, ranging from 21.5% to 58.3%.
CONCLUSION: The prevalence of serious spinal pathologies and nonspinal conditions varied greatly. Differential diagnostic strategies with clear care pathways need to be available to ensure a prompt diagnosis of serious spinal pathologies and nonspinal conditions.
STUDY REGISTRATION: PROSPERO CRD42022352568.
METHODS: Literature searches were conducted in 6 electronic databases. Observational studies investigating the prevalence of serious spinal pathologies and nonspinal conditions in adults seeking health care for a complaint of low back pain were considered eligible. Risk of bias was assessed with a tool for prevalence studies. Meta-analyses using random effect models were conducted to obtain pooled prevalence estimates.
RESULTS: Eleven studies were included in this review; most (64%) were at low risk of bias. With moderate certainty of evidence, the pooled prevalence of serious spinal pathologies was 2.9% (95% confidence interval: 1.6% to 5.2%) in people with a complaint of low back pain at presentation. The prevalence, however, varied by setting: primary care, 0.8%; emergency department, 2.1%; secondary care, 4.6%; and tertiary care, 6.9%. With moderate certainty of evidence, the prevalence of individual serious spinal pathologies ranged from 0.3% for cauda equina syndrome to 2.4% for spinal fracture. The prevalence of nonspinal conditions from Australian emergency department studies varied greatly, ranging from 21.5% to 58.3%.
CONCLUSION: The prevalence of serious spinal pathologies and nonspinal conditions varied greatly. Differential diagnostic strategies with clear care pathways need to be available to ensure a prompt diagnosis of serious spinal pathologies and nonspinal conditions.
STUDY REGISTRATION: PROSPERO CRD42022352568.