Inpatient gradual diagnostics and its relevance for determining treatment strategies in lumbar back pain

Table 2 Changes of treatment strategy after inpatient gradual diagnostics (IGD)

Treatment strategy	Number of cases/ Total cases	Percentage
Strategy changed through IGD	45/116	39
Strategy unaltered after IGD	71/116	61
No surgery indicated before IGD	33/116	28
Surgery indicated before IGD	83/116	72
Indication for conservative approach confirmed by IGD	25/33	76
Surgery indicated by IGD^a	8/33	24
Indication for surgery confirmed by IGD	65/83	78
Indication for surgery refused by IGD^b	18/83	22
Scope of initially suggested surgical procedure extended by IGD (without cases with no indication for surgery before IGD)^c	17/65	26
Scope of indicated surgical procedure reduced by IGD (without cases with no indication for surgery after IGD)^d	2/65	3

^aThree two-segment fusions, three one-segment fusions, two one-segment decompressions
^bIn two cases, indication for total hip arthroplasty
^cExtension of surgical approach: one segment cranially (n = 6), one segment caudally (n = 4), one segment cranially and one caudally (n = 1), change of decompression to fusion surgery (n = 5), monosegmental lumbar fusion in addition to removal of sacroiliac joint screws (n = 1)
^dChange of fusion surgery to decompression (n = 1), reduction of fusion scope by two segments (n = 1)

ISSN: 1471-2474