Low back pain emergencies

Luis A. Serrano, Timothy Maus, J. D. Bartleson

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Low back pain (LBP) is exceedingly common. Most patients with LBP present acutely or subacutely. The clinician is frequently faced with the task of determining whether or not the individual LBP patient has an emergent or soon-to-be-emergent underlying condition. The approach to the patient with acute or subacute LBP includes a search for red fl ags in the history and careful physical and neurological examinations that can indicate the likelihood of an underlying urgent or emergent condition. In the absence of red fl ags, patients can be treated conservatively for 1 month or more without diagnostic testing. Patients who have or develop red fl ags should undergo urgent and sometimes emergent investigation. LBP emergencies include infections (vertebral osteomyelitis and/or epidural abscess), primary and metastatic spine tumors, thoracic aortic dissection (TAD), expansion or rupture of an abdominal aortic aneurysm (AAA), a large lumbar disk protrusion or extrusion with compression of the cauda equina, and thoracolumbar fractures.

Original languageEnglish (US)
Title of host publicationEmergency Neurology
PublisherSpringer US
Pages33-69
Number of pages37
ISBN (Electronic)9780387885858
ISBN (Print)9780387885841
DOIs
StatePublished - Jan 1 2012

Keywords

  • Abdominal aortic aneurysm
  • Cauda equina syndrome
  • Low back pain
  • Spinal epidural abscess
  • Spine tumor
  • Thoracic aortic dissection
  • Thoracolumbar fracture
  • Vertebral compression fracture
  • Vertebral osteomyelitis

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Serrano, L. A., Maus, T., & Bartleson, J. D. (2012). Low back pain emergencies. In Emergency Neurology (pp. 33-69). Springer US. https://doi.org/10.1007/978-0-387-88585-8_2