Semin Neurol 2016; 36(05): 456-461
DOI: 10.1055/s-0036-1585071
Review Article
Society of Indian Hand & Microsurgeons

Low Back Pain and Spondylosis

Benjamin D. Elder
1   Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Timothy F. Witham
1   Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

Publication Date:
23 September 2016 (online)

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Abstract

Low back pain is highly prevalent, affecting a vast majority of the adult population at some point in their lifetime. Thorough history and physical examination is critically important in evaluating these patients and screening for potentially serious conditions. Imaging should be guided by the history and physical examination, particularly when there is concern for serious conditions and/or a focal neurological deficit present. Adequate treatment of patients with low back pain often requires a multidisciplinary approach, involving several medical specialties. Patients with acute axial low back pain typically have a favorable prognosis with resolution over 4 weeks, regardless of treatment. However, patients with chronic low back pain should be transitioned to pain management strategies with multidisciplinary care, in order to maximize function and limit disability. Referral to a spine surgeon is indicated urgently for a severe, progressive neurological deficit, particularly new motor weakness or cauda equina syndrome, and can be done electively for patients with degenerative disorders without a focal deficit.