Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study

Lenza, Mario; Buchbinder, Rachelle; Staples, Margaret P.; dos Santos, Oscar F.P.; Brandt, Reynaldo A.; Lottenberg, Claudio L.; Cendoroglo, Miguel; Ferretti, Mario

doi:10.1186/s12891-017-1712-0

BMC Musculoskeletal Disorders

Table 1 Comparison of the diagnoses made by the community spinal surgeons compared with the HIAE physiatrist and orthopaedic surgeon, agreement shown in bold (N = 485)

From: Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study

Diagnosis of the community spinal surgeon
Diagnosis of the HIAE physiatrist and orthopaedic surgeon	Cervical radiculopathy^a	Cervical myelopathy	Neck pain^b	Lumbar radiculopathy^c	Lumbar canal stenosis	Low back pain^d	Failed spine surgery^e	Not reported	Total
Cervical radiculopathy^a	36		2	1					39
Cervical radiculopathy, different level	8								8
Cervical myelopathy		2							2
Neck pain^b	14		4						18
Lumbar radiculopathy^c				116		2			118
Lumbar radiculopathy, different level				18					18
Lumbar canal stenosis				1	7				8
Low back pain^d				75	4	66	7	1	153
Thoracic pain			1	2					3
Coccyx pain				1					1
Failed spine surgery^e							26		26
Failed spine surgery, different level			1		1	2			4
Non-spinal condition^f	41		9	20		13	4		87
Total	99	2	17	234	12	83	37	1	485

^aIncludes cervical disc herniation and cervical discopathy; ^bIncludes cervical zygapophyseal pain, cervical osteoarthritis, cervical spondylosis and mechanical neck pain; ^cIncludes lumbar disc herniation and lumbar discopathy; ^dIncludes lumbar zygapophyseal pain, lumbar osteoarthritis, lumbar spondylosis’, ‘mechanical low back pain’, ‘lumbar instability’, ‘spondylodisciitis’ and ‘spondylolisthesis’; ^eIncludes all procedures that need another surgical intervention (failed back, mechanical implant failure of lumbar fusion, non-union of cervical fusion, non-union of lumbar fusion, complication of disc arthroplasty, complication of intraspinous spacer)
^fFirst opinion of cervical radiculopathy was diagnosed by the second opinion as myofascial pain syndrome (N = 27), carpal tunnel syndrome (N = 5) shoulder impingement (N = 3), headache (N = 2), calcific tendinitis (N = 1), dizziness (N = 1), diabetic polyneuropathy N = 1) and cubital tunnel syndrome (N = 1); first opinion of neck pain was diagnosed by the second opinion as myofascial syndrome (N = 8) and shoulder impingement (N = 1); first opinion of lumbar radiculopathy was diagnosed by the second opinion as myofascial syndrome (N = 14), peripheral neuropathy (N = 1), medication induced polyneuropathy (N = 1), post-polio syndrome (N = 1), trochanteric bursitis (N = 1), meralgia paraesthetica (N = 1) and rheumatoid arthritis (N = 1); first opinion of lumbar instability was diagnosed by the second opinion as myofascial syndrome (N = 1); first opinion of low back pain was diagnosed by the second opinion as myofascial syndrome (N = 7), trochanteric bursitis (N = 2), vascular claudication (N = 1), sacroiliitis (N = 1) and rheumatoid arthritis (N = 1); and first opinion of failed spine surgery was diagnosed by the second opinion as myofascial syndrome (N = 2). Osteoarthritis hip (N = 1) and reflex sympathetic dystrophy (N = 1)

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ISSN: 1471-2474

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