Clinical Practice Guidelines on Interventional Management of Low Back Pain: A Synthesis of Recommendations
PM R - 2022 - Olivier - Clinical ...
AuthorsOlivier, Timothy J
Baltich Nelson, Becky
Sharma, G Sunny
Annaswamy, Thiru M
UMass Chan AffiliationsLamar Soutter Library
Document TypeAccepted Manuscript
KeywordsDissemination and Implementation Research
Health Care Delivery
MetadataShow full item record
AbstractObjective: To summarize the recommendations on the interventional management of subacute and chronic non-radicular low back pain (LBP) from the 21 quality-appraised CPGs identified in the previously published paper: "Quality of Clinical Practice Guidelines on Interventional Management of Low Back Pain: A Systematic Review". By disseminating this information, we aim to facilitate the implementation of these recommendations into clinical practice. Literature survey: Electronic bibliographic databases, guideline databases and grey literature were searched from January 2016 to January 2020 to identify CPGs that met study criteria. Methodology: 21 CPGs were quality-appraised and interventional management recommendations were extracted and organized into several treatment categories including epidural steroid injections (ESIs), radiofrequency procedures (RF), facet injections, sacroiliac injections (SI), and prolotherapy. Within each treatment category, the recommendations were organized based on 2 factors: quality of CPG and strength of recommendation. Synthesis: Overall, there was no consistency in recommendations for or against any interventional procedure, even when accounting for the quality of the CPG. In all of the CPGs reviewed, the most common strength of recommendation was weakly-for. The second, third and fourth most common strength of recommendations were inconclusive, weakly-against and strongly-against respectively and the least common was strongly-for. The treatment categories with the greatest number of recommendations were RF procedures (most common strength of recommendation-weakly for) and facet procedures. Among the high-quality CPGs, the most common strength of recommendation was inconclusive. Conclusions: Most of the interventional management recommendations for management of non-radicular LBP in the 21 CPGs appraised in this review were either weakly-for, weakly-against or inconclusive, with several recommendations within each treatment category contradicting each other. AGREE II quality appraisals of CPGs on interventional management of LBP were of unclear utility in guiding clinical implementation.
SourceOlivier TJ, Konda C, Pham T, Baltich Nelson B, Patel A, Sharma GS, Trivedi K, Annaswamy TM. Clinical Practice Guidelines on Interventional Management of Low Back Pain: A Synthesis of Recommendations. PM R. 2022 Dec 12. doi: 10.1002/pmrj.12930. Epub ahead of print. PMID: 36507598.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/51484
RightsThis is the peer reviewed version of the following article: Olivier TJ, Konda C, Pham T, Baltich Nelson B, Patel A, Sharma GS, Trivedi K, Annaswamy TM. Clinical Practice Guidelines on Interventional Management of Low Back Pain: A Synthesis of Recommendations. PM R. 2022 Dec 12. doi: 10.1002/pmrj.12930, which has been published in final form at https://https://doi.org/10.1002/pmrj.12930. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. Accepted manuscript posted after 12-month embargo as allowed by the publisher's self-archiving policy at https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html.