Prognostic factors in non-surgically treated sciatica: A systematic review

BMC Musculoskeletal Disorders

Research Article

Kate M Dunn¹  Julie Ashworth¹  Kika Konstantinou¹ 

[1] Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, UK;

关键词: Prognostic Factor;    Disc Herniation;    Spinal Stenosis;    Significant Prognostic Factor;    Potential Prognostic Factor;   

DOI  :  10.1186/1471-2474-12-208

 received in 2011-05-18, accepted in 2011-09-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundWhen present sciatica is considered an obstacle to recovery in low back pain patients, yet evidence is limited regarding prognostic factors for persistent disability in this patient group. The aim of this study is to describe and summarise the evidence regarding prognostic factors for sciatica in non-surgically treated cohorts. Understanding the prognostic factors in sciatica and their relative importance may allow the identification of patients with particular risk factors who might benefit from early or specific types of treatment in order to optimise outcome.MethodsA systematic literature search was conducted using Medline, EMBASE and CINAHL electronic databases. Prospective cohort studies describing subjects with sciatica and measuring pain, disability or recovery outcomes were included. Studies of cohorts comprised entirely of surgically treated patients were excluded and mixed surgically and conservatively treated cohorts were included only if the results were analysed separately by treatment group or if the analysis was adjusted for treatment.ResultsSeven adequate or high quality eligible studies were identified. There were conflicting but mainly negative results regarding the influence of baseline pain severity, neurological deficit, nerve root tension signs, duration of symptoms and radiological findings on outcome. A number of factors including age, gender, smoking, previous history of sciatica and heaviness of work do not appear to influence outcome. In contrast to studies of low back pain and purely surgically treated sciatica cohorts, psychological factors were rarely investigated.ConclusionsAt present, the heterogeneity of the available studies makes it difficult to draw firm conclusions about sciatica prognosis, and highlights the need for further research for this group of patients. Large scale prospective studies of high methodological quality, using a well-defined, consistent definition of sciatica and investigating psychosocial factors alongside clinical and radiological findings are recommended to identify prognostic factors in this population.

【 授权许可】

CC BY   
© Ashworth et al; licensee BioMed Central Ltd. 2011