Evidence-based guidelines developed for disc herniation

Evidence-based guidelines developed for disc herniation

(HealthDay)—Evidence-based clinical guidelines have been developed for management of lumbar disc herniation with radiculopathy; the guidelines have been published in the Jan. 1 issue of The Spine Journal.

D. Scott Kreiner, M.D., from Ahwatukee Sports and Spine in Phoenix, and colleagues conducted a systematic literature review and developed evidence-based guidelines to assist in the diagnosis and treatment of lumbar disc herniation with radiculopathy.

The researchers formulated 29 clinical questions relating to natural history, diagnosis and imaging, outcome measures, medical intervention/treatment, surgical treatment, and value of spinal care. The guidelines emphasize that is the most appropriate noninvasive test for confirming the presence of lumbar disc herniation. Computed tomography (CT) scans, myelography, and/or CT myelography are recommended for confirming herniation in patients with consistent history and physical examination findings. Insufficient evidence limited recommendations relating to medical/interventional treatment; transforaminal epidural steroid injection is recommended for short-term pain relief, and endoscopic percutaneous discectomy is recommended for carefully selected patients. Patients should undergo preoperative psychological assessment, as those with signs of psychological distress have worse outcomes after surgery. Earlier surgery is associated with faster recovery and improved long-term outcomes. For patients whose symptoms warrant surgical intervention, discectomy provides more effective relief than medical/interventional care, while for those with less severe symptoms, short and long-term relief are provided by surgery or medical/interventional care.

"The has been created using the techniques of evidence-based medicine and best available evidence to aid practitioners in the care of with symptomatic lumbar with radiculopathy," the authors write.

Several authors disclosed financial ties to the medical device and medical technology industries.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Improved driving reaction times after lumbar disc sx

Jan 15, 2013

(HealthDay)—Driving reaction times (DRTs), which are increased for patients with radiculopathy, improve after lumbar disc surgery, according to a study published in the November issue of the European Sp ...

MRI findings linked to effect of lumbar spine surgery

Jun 26, 2013

(HealthDay)—Certain findings on magnetic resonance imaging (MRI) are linked with surgical outcome in patients with lumbar intervertebral disc herniation, according to research published in the June 15 issue ...

Updated guidelines available for lumbar spinal stenosis

Aug 08, 2013

(HealthDay)—Updated evidence-based guidelines on the diagnosis and treatment of degenerative lumbar spinal stenosis are now available, according to report published in the July issue of The Spine Journal.

Less benefit for obese with lumbar disc herniation tx

Feb 08, 2013

(HealthDay)—Obese patients derive less benefit from both operative and non-operative lumbar disc herniation treatment, according to a study published in the Jan. 2 issue of The Journal of Bone & Joint Su ...

Recommended for you

Filipino tests negative for Middle East virus

14 minutes ago

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

US orders farms to report pig virus infections

Apr 18, 2014

The U.S. government is starting a new program to help monitor and possibly control the spread of a virus that has killed millions of pigs since showing up in the country last year.

Foreigner dies of MERS in Saudi

Apr 18, 2014

A foreigner has died after she contracted MERS in the Saudi capital, the health ministry said on announced Friday, bringing the nationwide death toll to 73.

Vietnam battles fatal measles outbreak

Apr 18, 2014

Vietnam is scrambling to contain a deadly outbreak of measles that has killed more than 100 people, mostly young children, and infected thousands more this year, the government said Friday.

New clues on tissue scarring in scleroderma

Apr 18, 2014

A discovery by Northwestern Medicine scientists could lead to potential new treatments for breaking the cycle of tissue scarring in people with scleroderma.

User comments