Is NICE guidance for identifying lumbar nerve root compression misguided?

Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar n...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Germon, Tim [verfasserIn] Singleton, William [verfasserIn] Hobart, Jeremy [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2014

Schlagwörter:	Radicular pain Back pain Guidelines

Übergeordnetes Werk:	Enthalten in: European spine journal - Berlin : Springer, 1992, 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24
Übergeordnetes Werk:	volume:23 ; year:2014 ; number:Suppl 1 ; day:19 ; month:02 ; pages:20-24

Links:	Volltext

DOI / URN:	10.1007/s00586-014-3233-y

Katalog-ID:	SPR006915329

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520			\|a Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination.
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publishDate	2014
allfields	10.1007/s00586-014-3233-y doi (DE-627)SPR006915329 (SPR)s00586-014-3233-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Germon, Tim verfasserin aut Is NICE guidance for identifying lumbar nerve root compression misguided? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination. Radicular pain (dpeaa)DE-He213 Back pain (dpeaa)DE-He213 Guidelines (dpeaa)DE-He213 Singleton, William verfasserin aut Hobart, Jeremy verfasserin aut Enthalten in European spine journal Berlin : Springer, 1992 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24 (DE-627)268757550 (DE-600)1472721-3 1432-0932 nnns volume:23 year:2014 number:Suppl 1 day:19 month:02 pages:20-24 https://dx.doi.org/10.1007/s00586-014-3233-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE AR 23 2014 Suppl 1 19 02 20-24
spelling	10.1007/s00586-014-3233-y doi (DE-627)SPR006915329 (SPR)s00586-014-3233-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Germon, Tim verfasserin aut Is NICE guidance for identifying lumbar nerve root compression misguided? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination. Radicular pain (dpeaa)DE-He213 Back pain (dpeaa)DE-He213 Guidelines (dpeaa)DE-He213 Singleton, William verfasserin aut Hobart, Jeremy verfasserin aut Enthalten in European spine journal Berlin : Springer, 1992 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24 (DE-627)268757550 (DE-600)1472721-3 1432-0932 nnns volume:23 year:2014 number:Suppl 1 day:19 month:02 pages:20-24 https://dx.doi.org/10.1007/s00586-014-3233-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE AR 23 2014 Suppl 1 19 02 20-24
allfields_unstemmed	10.1007/s00586-014-3233-y doi (DE-627)SPR006915329 (SPR)s00586-014-3233-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Germon, Tim verfasserin aut Is NICE guidance for identifying lumbar nerve root compression misguided? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination. Radicular pain (dpeaa)DE-He213 Back pain (dpeaa)DE-He213 Guidelines (dpeaa)DE-He213 Singleton, William verfasserin aut Hobart, Jeremy verfasserin aut Enthalten in European spine journal Berlin : Springer, 1992 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24 (DE-627)268757550 (DE-600)1472721-3 1432-0932 nnns volume:23 year:2014 number:Suppl 1 day:19 month:02 pages:20-24 https://dx.doi.org/10.1007/s00586-014-3233-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE AR 23 2014 Suppl 1 19 02 20-24
allfieldsGer	10.1007/s00586-014-3233-y doi (DE-627)SPR006915329 (SPR)s00586-014-3233-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Germon, Tim verfasserin aut Is NICE guidance for identifying lumbar nerve root compression misguided? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination. Radicular pain (dpeaa)DE-He213 Back pain (dpeaa)DE-He213 Guidelines (dpeaa)DE-He213 Singleton, William verfasserin aut Hobart, Jeremy verfasserin aut Enthalten in European spine journal Berlin : Springer, 1992 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24 (DE-627)268757550 (DE-600)1472721-3 1432-0932 nnns volume:23 year:2014 number:Suppl 1 day:19 month:02 pages:20-24 https://dx.doi.org/10.1007/s00586-014-3233-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE AR 23 2014 Suppl 1 19 02 20-24
allfieldsSound	10.1007/s00586-014-3233-y doi (DE-627)SPR006915329 (SPR)s00586-014-3233-y-e DE-627 ger DE-627 rakwb eng 610 ASE 44.83 bkl Germon, Tim verfasserin aut Is NICE guidance for identifying lumbar nerve root compression misguided? 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination. Radicular pain (dpeaa)DE-He213 Back pain (dpeaa)DE-He213 Guidelines (dpeaa)DE-He213 Singleton, William verfasserin aut Hobart, Jeremy verfasserin aut Enthalten in European spine journal Berlin : Springer, 1992 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24 (DE-627)268757550 (DE-600)1472721-3 1432-0932 nnns volume:23 year:2014 number:Suppl 1 day:19 month:02 pages:20-24 https://dx.doi.org/10.1007/s00586-014-3233-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.83 ASE AR 23 2014 Suppl 1 19 02 20-24
language	English
source	Enthalten in European spine journal 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24 volume:23 year:2014 number:Suppl 1 day:19 month:02 pages:20-24
sourceStr	Enthalten in European spine journal 23(2014), Suppl 1 vom: 19. Feb., Seite 20-24 volume:23 year:2014 number:Suppl 1 day:19 month:02 pages:20-24
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Radicular pain Back pain Guidelines
dewey-raw	610
isfreeaccess_bool	false
container_title	European spine journal
authorswithroles_txt_mv	Germon, Tim @@aut@@ Singleton, William @@aut@@ Hobart, Jeremy @@aut@@
publishDateDaySort_date	2014-02-19T00:00:00Z
hierarchy_top_id	268757550
dewey-sort	3610
id	SPR006915329
language_de	englisch
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Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. 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author	Germon, Tim
spellingShingle	Germon, Tim ddc 610 bkl 44.83 misc Radicular pain misc Back pain misc Guidelines Is NICE guidance for identifying lumbar nerve root compression misguided?
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topic_title	610 ASE 44.83 bkl Is NICE guidance for identifying lumbar nerve root compression misguided? Radicular pain (dpeaa)DE-He213 Back pain (dpeaa)DE-He213 Guidelines (dpeaa)DE-He213
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title	Is NICE guidance for identifying lumbar nerve root compression misguided?
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title_full	Is NICE guidance for identifying lumbar nerve root compression misguided?
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title_sort	is nice guidance for identifying lumbar nerve root compression misguided?
title_auth	Is NICE guidance for identifying lumbar nerve root compression misguided?
abstract	Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination.
abstractGer	Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination.
abstract_unstemmed	Purpose To determine the extent to which the clinical manifestations of a cohort of people undergoing surgery for lumbosacral nerve root compression satisfy those described in The National Institute for Health and Care Excellence (NICE) guidance. Method We studied consecutive admissions for lumbar nerve root decompression surgery at two neurosurgical units. Pre-operatively, each person’s clinical manifestations were documented and compared with NICE’s description. Post-operatively, at three time points (within 48 h, 3 months, 12 months), each person rated their symptoms as either better, the same, or worse. Results Pre-operatively, one person (0.8 %), from 123 admissions, under 20 different consultant neurosurgeons, had manifestations consistent with NICE’s clinical description of lumbar nerve root compression. Post-operatively, self-reported benefit associated with surgery appeared high, at all three time points (78–91 %), supporting the diagnosis of symptomatic nerve root compression and the value of surgery. Conclusions In this small sample, from two units, NICE’s description of the clinical manifestations of lumbar nerve root compression did not describe 99 % of people having surgery for it. Using NICE’s definition to triage people with low back pain could result in prolonged symptoms and delayed treatment. Diagnosing lumbar nerve root compression is complex. NICE’s guidance requires examination.
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title_short	Is NICE guidance for identifying lumbar nerve root compression misguided?
url	https://dx.doi.org/10.1007/s00586-014-3233-y
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