ArticleArchives of trauma research2014
The reliability of red flags in spinal cord compression.
Article in Archives of trauma research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Diagnosis Value of Patient Evaluation Components Applicable in Primary Care Settings for the Diagnosis of Low Back Pain: A Scoping Review of Systematic Reviews.Journal of clinical medicine · 2023Article
- A Clinical Prediction Tool for MRI in Emergency Department Patients with Spinal Infection.The western journal of emergency medicine · 2021Observational
- Cauda equina compression in metastatic prostate cancer.BMJ case reports · 2020Article
- The screening process of a patient with low back pain and suspected thoracic myelopathy: a case report.The Journal of manual & manipulative therapy · 2018Article
- Red flags presented in current low back pain guidelines: a review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Review
- Evidence base and future research directions in the management of low back pain.World journal of orthopedics · 2016Article
- Acute Back Pain: A Survey of Primary Health Care Physicians' Awareness and Knowledge of "Red Flag" Signs.Saudi journal of medicine & medical sciencesArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute low back pain is a common cause for presentation to the emergency department (ED). Since benign etiologies account for 95% of cases, red flags are used to identify sinister causes that require prompt management.
objectivesWe assessed the effectiveness of red flag signs used in the ED to identify spinal cord and cauda equine compression. PATIENTS AND
methodsIt was a retrospective cohort study of 206 patients with acute back pain admitted from the ED. The presence or absence of the red flag symptoms was assessed against evidence of spinal cord or cauda equina compression on magnetic resonance imaging (MRI).
resultsOverall, 32 (15.5%) patients had compression on MRI. Profound lower limb neurologic examination did not demonstrate a statistically significant association with this finding. The likelihood ratio (LR) for bowel and bladder dysfunction (sensitivity of 0.65 and specificity of 0.73) was 2.45. Saddle sensory disturbance (sensitivity of 0.27 and specificity of 0.87) had a LR of 2.11. When both symptoms were taken together (sensitivity of 0.27 and specificity of 0.92), they gave a LR of 3.46.
conclusionsThe predictive value of the two statistically significant red flags only marginally raises the clinical suspicion of spinal cord or cauda equina compression. Effective risk stratification of patients presenting to the ED with acute back pain is crucial; however, this study did not support the use of these red flags in their current form.
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