Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain

Abstract

BACKGROUND CONTEXT: The North American Spine Society's (NASS) Evidence Based Clinical Guideline for the Diagnosis and Treatment of Low Back Pain features evidence-based recommendations for diagnosing and treating adult patients with nonspecific low back pain. The guideline is intended to reflect contemporary treatment concepts for nonspecific low back pain as reflected in the highest quality clinical literature available on this subject as of February 2016.

PURPOSE: The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with nonspecific low back pain. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition.

STUDY DESIGN: This is a guideline summary review.

METHODS: This guideline is the product of the Low Back Pain Work Group of NASS' Evidence-Based Clinical Guideline Development Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questions to address in the guideline. The literature search strategy was developed in consultation with medical librarians. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in webcasts and in-person recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guideline was submitted to an internal and external peer review process and ultimately approved by the NASS Board of Directors.

RESULTS: Eighty-two clinical questions were addressed, and the answers are summarized in this article. The respective recommendations were graded according to the levels of evidence of the supporting literature.

CONCLUSIONS: The evidence-based clinical guideline has been created using techniques of evidence-based medicine and best available evidence to aid practitioners in the diagnosis and treatment of adult patients with nonspecific low back pain. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flowchart, suggestions for future research, and all of the references, is available electronically on the NASS website at https://www.spine.org/ResearchClinicalCare/QualityImprovement/ClinicalGuidelines.aspx.

Links

• doi:10.1016/j.spinee.2020.04.006

BibTeX (Download)

@article{pmid32333996,
title = {Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain},
author = {D Scott Kreiner and Paul Matz and Christopher M Bono and Charles H Cho and John E Easa and Gary Ghiselli and Zoher Ghogawala and Charles A Reitman and Daniel K Resnick and William C Watters and Thiru M Annaswamy and Jamie Baisden and Walter S Bartynski and Shay Bess and Randall P Brewer and R Carter Cassidy and David S Cheng and Sean D Christie and Norman B Chutkan and Bernard Allan Cohen and Simon Dagenais and Dennis E Enix and Paul Dougherty and S Raymond Golish and Padma Gulur and Steven W Hwang and Cumhur Kilincer and Jeffrey A King and Adam C Lipson and Anthony J Lisi and Richard J Meagher and John E O'Toole and Paul Park and Murat Pekmezci and Daniel R Perry and Ravi Prasad and David A Provenzano and Kris E Radcliff and Gazanfar Rahmathulla and Tom E Reinsel and Robert L Rich and Daniel S Robbins and Karie A Rosolowski and Jonathan N Sembrano and Anil K Sharma and Alison A Stout and Christopher K Taleghani and Ryan A Tauzell and Terry Trammell and Yakov Vorobeychik and Amy M Yahiro},
doi = {10.1016/j.spinee.2020.04.006},
issn = {1878-1632},
year  = {2020},
date = {2020-07-01},
urldate = {2020-07-01},
journal = {Spine J},
volume = {20},
number = {7},
pages = {998--1024},
abstract = {BACKGROUND CONTEXT: The North American Spine Society's (NASS) Evidence Based Clinical Guideline for the Diagnosis and Treatment of Low Back Pain features evidence-based recommendations for diagnosing and treating adult patients with nonspecific low back pain. The guideline is intended to reflect contemporary treatment concepts for nonspecific low back pain as reflected in the highest quality clinical literature available on this subject as of February 2016.

PURPOSE: The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with nonspecific low back pain. This article provides a brief summary of the evidence-based guideline recommendations for diagnosing and treating patients with this condition.

STUDY DESIGN: This is a guideline summary review.

METHODS: This guideline is the product of the Low Back Pain Work Group of NASS' Evidence-Based Clinical Guideline Development Committee. The methods used to develop this guideline are detailed in the complete guideline and technical report available on the NASS website. In brief, a multidisciplinary work group of spine care specialists convened to identify clinical questions to address in the guideline. The literature search strategy was developed in consultation with medical librarians. Upon completion of the systematic literature search, evidence relevant to the clinical questions posed in the guideline was reviewed. Work group members utilized NASS evidentiary table templates to summarize study conclusions, identify study strengths and weaknesses, and assign levels of evidence. Work group members participated in webcasts and in-person recommendation meetings to update and formulate evidence-based recommendations and incorporate expert opinion when necessary. The draft guideline was submitted to an internal and external peer review process and ultimately approved by the NASS Board of Directors.

RESULTS: Eighty-two clinical questions were addressed, and the answers are summarized in this article. The respective recommendations were graded according to the levels of evidence of the supporting literature.

CONCLUSIONS: The evidence-based clinical guideline has been created using techniques of evidence-based medicine and best available evidence to aid practitioners in the diagnosis and treatment of adult patients with nonspecific low back pain. The entire guideline document, including the evidentiary tables, literature search parameters, literature attrition flowchart, suggestions for future research, and all of the references, is available electronically on the NASS website at https://www.spine.org/ResearchClinicalCare/QualityImprovement/ClinicalGuidelines.aspx.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}