Mr Hassan Shafiq MBBS, MRCS ST2 Trauma and Orthopaedics, Royal London Hospital, London
Abstract
Abstract
Audit on Lumbar Spine Radiography on Lower Back Pain
Background:
The 2016 NICE guidance on management of low back pain with or without sciatica, proposes no useful role for lumbar radiography. The 2016 NICE guidance recommends to think about alternative diagnoses when examining or reviewing people with low back pain, particularly if they develop new or changed symptoms, and to exclude specific causes of low back pain, for example, cancer, infection, trauma or inflammatory disease such as spondyloarthritis [1]. This definition does not include radicular pain resulting from possible nerve root compression or cauda equina syndrome. iRefer provides guidance on the indications for lumbar radiography. In patients with chronic lumbar back pain (>6 weeks) with no clinical or serological indicators of infection or neoplasia (ie, no red flags) x-ray is only indicated if presentation suggests osteoporotic collapse in the elderly [2].
By reducing the number of lumbar spine radiographs performed inappropriately for low back pain patients can reach important points in the care pathway more rapidly also avoiding unnecessary radiation dose.
References:
Low back pain and sciatica in over 16s: assessment and management. NICE guideline [NG59] Published date: November 2016. https://www.nice.org.uk/guidance/ng59 [accessed 11 April 2018]
Royal College of Radiologists. iRefer: Making the best use of clinical radiology. RCR iRefer Guidelines v. 8. 2017. https://www.irefer.org.uk/ [accessed 11 April 2018]
