ENFOQUE DIAGNÓSTICO DE LA LUMBALGIA - PARTE 1: REVISIÓN SISTEMÁTICA DE LA LITERATURA
DOI:
https://doi.org/10.51437/nj.v25i2.46Keywords:
Dolor de espalda, dolor lumbar, espondilosis lumbosacra, diagnóstico, diagnóstico diferencial, diagnóstico temprano, diagnóstico tardíoAbstract
Introducción: El dolor lumbar es un importante motivo de consulta, que genera costos a los sistemas de salud. Evaluarlo es desafiante; de aquí la necesidad de realizar una búsqueda sistemática, de una herramienta: práctica, reproducible, que ayude a consensuar conceptos y facilite el enfoque.
Objetivo: Determinar si existe en la literatura, en español o inglés, un método diagnóstico: simple, aplicable y orientador para el abordaje clínico del dolor lumbar, agudo y crónico, en mayores de 18 años.
Materiales y métodos: Se realizó una revisión sistemática, en español e inglés; utilizando MESH o DECS: Low back pain, dolor lumbar, lumbar pain, lumbar ache, lumbosacral spondylosis, diagnosis, differential diagnosis, early diagnosis, delayed diagnosis ; Filtros: Incluyendo publicaciones (2013 - 2018), excluyendo reportes de casos, cartas al editor y artículos en otro idioma al inglés o español, eliminando los que por título y resumen, no se correlacionaron con este estudio. Se realizaron tres rondas de valoración de los artículos seleccionados. Evaluando la confianza y calidad de la evidencia usando CASP y CERQual.
Resultados: De 5571 trabajos, se seleccionaron 111, que por título daban respuesta a la pregunta, se excluyeron 82 trabajos, por baja calidad metodológica, presencia de sesgos o resumen no relacionado con este trabajo. Se excluyeron 17 trabajos más, por no cumplir con criterios de inclusión. Finalmente analizándose 12 artículos.
Conclusión: La información en la literatura es insuficiente, para encontrar un método diagnóstico: simple, aplicable y orientador, en el abordaje clínico del dolor lumbar; De ahí, la necesidad en la creación de un algoritmo clínico-diagnóstico, que permita abordar de manera global y simple el dolor lumbar.
References
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Manchikanti, L., Singh, V., Falco, F.J.E., Ramsin M., B., Joshua A., H., 2014. Epidemiology of Low Back Pain in Adults - Manchikanti - 2014 - Neuromodulation: Technology at the Neural Interface - Wiley Online Library.
Manchikanti, L., Soin, A., Benyamin, R., Singh, V., Falco, F., Calodney, A., Grami, V., Hirsch, J., 2018. An Update of the Systematic Appraisal of the Accuracy and Utility of Discography in Chronic Spinal Pain. - PubMed - NCBI.
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O’Sullivan, P., Waller, R., Wright, A., Gardner, J., Johnston, R., Payne, C., 2014. Sensory characteristics of chronic non-specific low back pain: a subgroup investigation. - PubMed - NCBI.
Oxman, A., Cook, D., Guyatt, G., 1994. Users’ guides to the medical literature. VI. How to use an overview. Evidence-Based Medicine Working Group. - PubMed - NCBI.
Premkumar, A., Godfrey, W., Gottschalk, M., Boden, S., 2018. Red Flags for Low Back Pain Are Not Always Really Red: A Prospective Evaluation of the Clinical Utility of Commonly Used Screening Questions for Lo... - PubMed - NCBI.
Smart, K., Blake, C., Staines, A., Thacker, M., Doody, C., 2012. Mechanisms-based classifications of musculoskeletal pain: part 1 of 3: symptoms and signs of central sensitisation in patients with low back (± leg... - PubMed - NCBI.
Suzuki, H., Kanchiku, T., Imajo, Y., Yoshida, Y., Nishida, N., Taguchi, T., 2016. Diagnosis and Characters of Non-Specific Low Back Pain in Japan: The Yamaguchi Low Back Pain Study.
Tomkins-Lane, C., Melloh, M., Lurie, J., Smuck, M., Battié, M.C., Freeman, B., Samartzis, D., Hu, R., Barz, T., Stuber, K., Schneider, M., Haig, A., Schizas, C., Cheung, J.P.Y., Mannion, A.F., Staub, L., Comer, C., Macedo, L., Ahn, S., Takahashi, K., Sandella, D., 2016. ISSLS Prize Winner: Consensus on the Clinical Diagnosis of L... : Spine.
Balagué, F., Mannion, A., Pellisé, F., Cedraschi, C., 2012. Non-specific low back pain. - PubMed - NCBI.
Balagué, F., Mannion, A.F., Pellisé, F., Cedraschi, C., 2017. Clinical update: low back pain - The Lancet.
Boriani, S., Weinstein, J.N., Biagini, R., 1997. Spine update primary bone tumors of the spine: Terminology and surgical staging — Northwestern Scholars.
Brayda-Bruno, M., 2017. Economic Issues, Risk Factors, and Litigation | Musculoskeletal Key.
Cano Arana, A., González Gil, T., Caballero López, J.B., 2010. Plantilla para ayudarte a entender un estudio cualitativo.
Chou, R., 2010. Pharmacological management of low back pain. - PubMed - NCBI.
Cruz-Medina, E., Coronado-Zarco, R., Arellano-Hernández, A., Nava-Bringas, T.I., Rodríguez-Leyva, J.A., Esparza-Ramos, S.B., 2014. Adaptación al español para la población mexicana con radiculopatía lumbar de la Escala de Evaluación Estandarizada del Dolor (StEP). ACTA ORTOPÉDICA MEXICANA 7.
Cunningham, S., 2013. Diagnostic accuracy: sensitivity and specificity of the ScreenAssist Lumbar Questionnaire in comparison with primary care provider tests and measures of low back pain: a pilot study.
Dieleman, J.L., Baral, R., Birger, M., Bui, A.L., Bulchis, A., Chapin, A., Hamavid, H., Horst, C., Johnson, E.K., Joseph, J., Lavado, R., Lomsadze, L., Reynolds, A., Squires, E., Campbell, M., DeCenso, B., Dicker, D., Flaxman, A.D., Gabert, R., Highfill, T., Naghavi, M., Nightingale, N., Templin, T., Tobias, M.I., Vos, T., Murray, C.J.L., 2016. US Spending on Personal Health Care and Public Health, 1996-2013. JAMA 316, 2627. https://doi.org/10.1001/jama.2016.16885
Enneking, W., Spanier, S., Goodman, M., 1980. A system for the surgical staging of musculoskeletal sarcoma. - PubMed - NCBI.
Flavell, C., Gordon, S., Marshman, L., 2016. Classification characteristics of a chronic low back pain population using a combined McKenzie and patho-anatomical assessment. - PubMed - NCBI.
Garland, E., 2012. Pain processing in the human nervous system: a selective review of nociceptive and biobehavioral pathways. - PubMed - NCBI.
Gómez Vega, J.C., Acevedo-González, J.C., 2019. Clinical diagnosis scale for pain lumbar of facet origin: systematic review of literature and pilot study. - PubMed - NCBI.
González, J.C., Quintero, S.T., 2014. Escala de diagnóstico (SI5) de disfunción de la articulación sacroiliaca: estudio piloto 21, 8.
Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., Williams, G., Smith, E., Vos, T., Barendregt, J., Murray, C., Burstein, R., Buchbinder, R., 2014. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. - PubMed - NCBI.
Hurwitz, E., Randhawa, K., Yu, H., Côté, P., Haldeman, S., 2018. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. - PubMed - NCBI.
International Standards for Neurological Classification of SCI (ISNCSCI) Worksheet - American Spinal Injury Association [WWW Document], 2019. URL https://asia-spinalinjury.org/international-standards-neurological-classification-sci-isncsci-worksheet/ (accessed 10.17.19).
Juanola Roura, X., Collantes Estévez, E., León Vázquez, F., Torres Villamor, A., García Yébenes, M.J., Carmona, L., Queiro Silva, R., 2015. Recomendaciones para la detección, investigación y derivación del dolor lumbar inflamatorio en Atención Primaria 9.
Juanola, X., Fernández-Sueiro, J.L., Torre-Alonso, J.C., Santiago, R.M., 2013. Comparison of 2 Referral Strategies for the Diagnosis of Axial Spondyloarthritis in Spain. The RADAR Study | Reumatología Clínica (English Edition).
Lewin, S., Glenton, C., Munthe-Kaas, H., Carlsen, B., Colvin, C.J., Gülmezoglu, M., Noyes, J., Booth, A., Garside, R., Rashidian, A., 2016. Using Qualitative Evidence in Decision Making for Health and Social Interventions: An Approach to Assess Confidence in Findings from Qualitative Evidence Syntheses (GRADE-CERQual). PLoS Med 13, e1002065. https://doi.org/10.1371/journal.pmed.1002065
Lozano-Quijada, C., Poveda-Pagán, E.J., Toledo-Marhuenda, J.V., Peral-Berná, M., Miralles-Bueno, J.J., 2014. Fiabilidad de los test de diagnóstico de disfunción sacroilíaca y de las pruebas exploratorias de la pelvis | Fisioterapia.
Manchikanti, L., Singh, V., Falco, F.J.E., Ramsin M., B., Joshua A., H., 2014. Epidemiology of Low Back Pain in Adults - Manchikanti - 2014 - Neuromodulation: Technology at the Neural Interface - Wiley Online Library.
Manchikanti, L., Soin, A., Benyamin, R., Singh, V., Falco, F., Calodney, A., Grami, V., Hirsch, J., 2018. An Update of the Systematic Appraisal of the Accuracy and Utility of Discography in Chronic Spinal Pain. - PubMed - NCBI.
Noyes, J., Booth, A., Flemming, K., Garside, R., Harden, A., Lewin, S., Pantoja, T., Hannes, K., Cargo, M., Thomas, J., 2018. Cochrane Qualitative and Implementation Methods Group guidance series-paper 3: methods for assessing methodological limitations, data extraction an... - PubMed - NCBI.
Noyes, J., Boothb, A., Cargo, M., Flemming, K., Garside, R., Hannes, K., Harden, A., Harris, J., Lewin, S., Pantoja, T., Thomas, J., 2017. Cochrane Qualitative and Implementation Methods Group guidance series—paper 1: introduction - Journal of Clinical Epidemiology.
O’Sullivan, P., Waller, R., Wright, A., Gardner, J., Johnston, R., Payne, C., 2014. Sensory characteristics of chronic non-specific low back pain: a subgroup investigation. - PubMed - NCBI.
Oxman, A., Cook, D., Guyatt, G., 1994. Users’ guides to the medical literature. VI. How to use an overview. Evidence-Based Medicine Working Group. - PubMed - NCBI.
Premkumar, A., Godfrey, W., Gottschalk, M., Boden, S., 2018. Red Flags for Low Back Pain Are Not Always Really Red: A Prospective Evaluation of the Clinical Utility of Commonly Used Screening Questions for Lo... - PubMed - NCBI.
Smart, K., Blake, C., Staines, A., Thacker, M., Doody, C., 2012. Mechanisms-based classifications of musculoskeletal pain: part 1 of 3: symptoms and signs of central sensitisation in patients with low back (± leg... - PubMed - NCBI.
Suzuki, H., Kanchiku, T., Imajo, Y., Yoshida, Y., Nishida, N., Taguchi, T., 2016. Diagnosis and Characters of Non-Specific Low Back Pain in Japan: The Yamaguchi Low Back Pain Study.
Tomkins-Lane, C., Melloh, M., Lurie, J., Smuck, M., Battié, M.C., Freeman, B., Samartzis, D., Hu, R., Barz, T., Stuber, K., Schneider, M., Haig, A., Schizas, C., Cheung, J.P.Y., Mannion, A.F., Staub, L., Comer, C., Macedo, L., Ahn, S., Takahashi, K., Sandella, D., 2016. ISSLS Prize Winner: Consensus on the Clinical Diagnosis of L... : Spine.
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Published
2019-12-05
How to Cite
gonzalez, andres felipe, Castañeda, M., & Pimienta, H. (2019). ENFOQUE DIAGNÓSTICO DE LA LUMBALGIA - PARTE 1: REVISIÓN SISTEMÁTICA DE LA LITERATURA. Español, 25(2), 9–29. https://doi.org/10.51437/nj.v25i2.46
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Revisión sistemática
