腰痛症および腰部神経根障害に対する非手術治療のデンマークのガイドライン

the Danish Health Authority2つのガイドラインに基づいた、最近(<12)発症した非特異的な腰痛症(non-specific low back painLBP)および腰部神経根障害( lumbar radiculopathyLR)に対する約20の非手術治療の推奨のまとめ。方法:GRADEアプローチに基づき、2つの多職種のワーキンググループが推奨を作った。結果:16の推奨がエビデンスに基づき、4つの意見の一致。LBPおよび LRの対処は、予後に関する情報, 警告となる所見, および活動性を維持するアドバイスを含むべき。もし治療が必要であれば、ガイドラインは患者教育、異なるタイプの管理された訓練、および徒手治療を示す。ガイドラインの推奨は、鍼、一律の画像検査、targeted治療, 椎間孔外glucocorticoid注射, paracetamol, NSAIDs,および opioidsに反対。まとめ:推奨は低度から中等度の質のエビデンス又は意見の一致に基づいたが、国際的なガイドラインと一致している。

Eur Spine J. 2017 Apr 20. doi: 10.1007/s00586-017-5099-2.[Epub ahead of print]

National Clinical Guidelines fornon-surgical treatment of patients with recent onset low back pain or lumbarradiculopathy.

Stochkendahl MJ1,2,3, Kjaer P4,5, Hartvigsen J4,6, Kongsted A4,6, Aaboe J5, Andersen M7, Andersen MØ8, Fournier G9, Højgaard B5,10, Jensen MB11, Jensen LD12, Karbo T13, Kirkeskov L14, Melbye M15, Morsel-Carlsen L16,17, Nordsteen J18, Palsson TS19, Rasti Z16, Silbye PF20, Steiness MZ21, Tarp S5,22, Vaagholt M23.

1

Department of Sports Science and ClinicalBiomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M,Denmark. m.jensen@nikkb.dk.

2

Nordic Institute of Chiropractic and ClinicalBiomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M,Denmark. m.jensen@nikkb.dk.

3

The Danish Health Authority, Islands Brygge67, 2300, Copenhagen S, Denmark. m.jensen@nikkb.dk.

4

Department of Sports Science and ClinicalBiomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M,Denmark.

5

The Danish Health Authority, Islands Brygge67, 2300, Copenhagen S, Denmark.

6

Nordic Institute of Chiropractic and ClinicalBiomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M,Denmark.

7

Frederiksberg Municipality, Smallegade 1,2000, Frederiksberg, Denmark.

8

Center for Spine Surgery and Research,Lillebaelt Hospital, Østre Hougvej 55, 5500, Middelfart, Denmark.

9

Center for Rheumatology and Spine Diseases,Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.

10

KORA-the Danish Institute for Local andRegional Government Research, Købmagergade 22, 1150, Copenhagen K, Denmark.

11

Research Unit for General Practice, Departmentof Clinical Medicine, Aalborg University, Fyrkildevej 7, 1, 9220, Aalborg O,Denmark.

12

Department of Occupational Medicine, DanishRamazzini Center, Aarhus University Hospital, Noerrebrogade 42, 8000, Aarhus C,Denmark.

13

Spine Unit, Department of Orthopaedic Surgery,The National University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.

14

Unit of Social Medicine, Department ofOccupational and Environmental Medicine, Frederiksberg Hospital, Ndr. Fasanvej57, Vej 8, 2.2, 2000, Frederiksberg, Denmark.

15

Aalborg Spine Clinic, Vingaardsgade 9, 9000,Aalborg, Denmark.

16

Department of Radiology, Bispebjerg andFrederiksberg Hospital, Ndr. Fasanvej 57, 2000, Frederiksberg, Denmark.

17

Department of Radiology,Rigshospitalet-Glostrup, Ndr. Ringvej 57, 2600, Glostrup, Denmark.

18

Copenhagen Back and Rehabilitation Centre,Mimersgade 41, 2200, Copenhagen, Denmark.

19

Department of Health Science and Technology, SMI®,Aalborg University, Frederik Bajers Vej 7D, 9220, Aalborg, Denmark.

20

, Bondetinget 24-01, 4000, Roskilde, Denmark.

21

Spine Section, Department of Neurosurgery,Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark.

22

Musculoskeletal Statistics Unit, The ParkerInstitute, Copenhagen University Hospital at Bispebjerg and Frederiksberg,Nordre Fasanvej 57, 2000, Copenhagen, Denmark.

23

, Hvidkildevej 62, 2400, København NV,Denmark.


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