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BMC Musculoskeletal Disorders

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Open Access 01-12-2016 | Research article

Inpatient gradual diagnostics and its relevance for determining treatment strategies in lumbar back pain

Authors: Ulf Krister Hofmann, Marco Gesicki, Falk Mittag

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Abstract

Background

Identifying patients who will benefit from spine surgery is still a challenge. This is especially the case when patients’ complaints and medical history, together with clinical observations, do not correspond to structural pathological changes. With inpatient gradual diagnostics (IGD)—the administration of analgesic and anti-inflammatory agents to a special area of interest—the effect of surgery can be temporarily simulated. From the patient’s statement about the alleviation of pain, the surgeon can draw conclusions concerning its causes. The aim of this study was to evaluate the extent to which IGD influences the decision about the nature and scope of surgical treatment strategies, and the way in which it does so, in patients with chronic lumbar back pain.

Methods

Clinical history and radiologic images were analysed retrospectively in 116 patients by two spine surgeons. Two therapeutic recommendations were developed for each patient: one was based on knowledge before IGD and one on knowledge after IGD.

Results

IGD changed the treatment strategy in 39 % of the analysed cases. Although the rate of recommended surgery was reduced by about 10 %, the indicated surgical scope increased in 25 % of cases.

Conclusions

IGD is an established concept used to determine therapeutic strategies in patients with chronic lumbar back pain. In our analysed cases, IGD led to highly relevant changes in recommendations for further surgical treatment.

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Title: Inpatient gradual diagnostics and its relevance for determining treatment strategies in lumbar back pain
Authors: Ulf Krister Hofmann
Marco Gesicki
Falk Mittag
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-016-1153-1

At a glance: The STEP trials

Springer Medicine

Inpatient gradual diagnostics and its relevance for determining treatment strategies in lumbar back pain

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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