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Diagnostics in Low Back Pain

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TLDR
The aim of the work presented in this thesis is to gain more insight into the diagnostic tools used in patients with low back pain by examining how lumbar MRI is currently used by general practitioners in the Netherlands.
Abstract
markdownThe aim of the work presented in this thesis is to gain more insight into the diagnostic tools used in patients with low back pain. In recent years, general practitioners in the Netherlands can refer low back pain patients for MRI of the lumbar spine themselves. However, data on the use of MRI by general practitioners in the Netherlands are still lacking. In the first part of this thesis, we examined how lumbar MRI is currently used by general practitioners in the Netherlands. Identifying subgroups of patients for whom different treatments are superior has been referred to as the ‘Holy Grail’ of low back pain research. One of the possible subgroups based on pathoanatomical findings are patients with degeneration of the spine. In the second part of this thesis, we performed an epidemiological study on the characteristics of lumbar disc degeneration.

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Journal Article

The management of pain.

D C Moore
Journal Article

Prognostic indicators of low back pain in primary care: five year prospective study

TL;DR: It is shown that pain intensity experienced during a period of primary care consultation, and patients' perception about whether their back pain will persist, were significant predictors of poor outcome at 6 months and at 5 years.
Journal Article

Imaging strategies for low-back pain: systematic review and meta-analysis

TL;DR: In this paper, the effects of routine, immediate lumbar imaging versus usual clinical care without immediate imaging on clinical outcomes in patients with low-back pain and no indication of serious underlying conditions were investigated.

Red flags to screen for malignancy in patients with low back pain

TL;DR: The diagnostic performance of clinical characteristics identified by taking a clinical history and conducting a physical examination ("red flags") to screen for spinal malignancy in patients presenting with low-back pain (LBP) was evaluated in this paper.

Plain film evaluation of degenerative disk disease at the lumbosacral junction

TL;DR: Analysis of results indicates that PDH is the most reliable and easily used criterion for detection of DDD at the LSJ, compared with ADH or LSA.
References
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- 15 Dec 2012 - 
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Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation

TL;DR: In this paper, the authors performed magnetic resonance imaging on sixty-seven individuals who had never had low-back pain, sciatica, or neurogenic claudication, and found that about one-third of the subjects were found to have a substantial abnormality.
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