Low Back Pain in Kids Rarely Serious

Posted by: admin on: December 1, 2011

Children and adolescents experience back pain some time in their lifetime. Studies prove 90% of the time cause is unknown & not serious. Have a look at this study done in Philadelphia


Low back pain in adolescents usually has an undiagnosable source, resolves spontaneously, and warrants a minimalist approach to tests and imaging, analysis of a large clinical series suggested.

Epidemiologic studies have suggested that about a third of children and adolescents have low back pain at some point in time. Early studies pointed toward potentially serious underlying neurologic conditions as the source of pain. More recent studies have shown that undiagnosable mechanical low back pain accounts for almost 80% of cases among adolescents

The prevalence of disparities provided the impetus for an investigation to characterize the population of children and adolescents with undiagnosed mechanical low back pain.
Miller and colleagues retrospectively reviewed medical records of patients ages 10 to 19, who were evaluated for mechanical low back pain of unknown etiology at Children’s Hospital of Philadelphia from 2000 to 2008.

The study population had a mean age of 14.3, and 63% of the patents were female. Miller said 13% of patients were excluded from analysis because of incomplete data.
Clinicians attributed the low back pain to nonspecific causes in 75.9% of patients. In more than 90% of the undiagnosable cases, the patients had fewer than three clinic visits.

Physicians diagnosed spondylolysis in 6.8% of patients, 86% whom had positive plain-film images. The condition was diagnosed by bone scan in 12.5% cases and by CT in 1.5%.
Bone scan or CT was performed in 90 patients who had negative plain-film images. The diagnostic yield was significantly higher for bone scans (53%) than for CT (27%). However, bone scans exposed patients to substantially more radiation than either plain-film imaging or CT.

From a cost perspective, a two-view plain-film image cost an average of $364 per patient. Four-view imaging increased the average cost to $511 without adding information to two-view imaging, Miller said.

Ref: http://www.medpagetoday.com/MeetingCoverage/AAP/29064?utm_source=WC&utm_medium=email&utm_campaign=Meeting_Roundup_AAP

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