TY - JOUR
T1 - Low Back Pain in Adolescents
T2 - A 1-Year Analysis of Eventual Diagnoses
AU - Yang, Scott
AU - Werner, Brian C.
AU - Singla, Anuj
AU - Abel, Mark F.
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Background: Back pain in adolescents is very common and often seen in the office for evaluation of potential spinal pathology. Pediatric back pain has often thought to be from serious identifiable causes such as spondylolysis, spondylolisthesis, tumor, or infection. A follow-up analysis of adolescents initially presenting with back pain to their eventual subsequent diagnosis within 1 year has not been reported on a large scale with a national sample. Methods: A national insurance database (PearlDiver Patient Records Database) was queried for ICD-9 codes to identify patients aged 10 to 19 years with back pain from 2007 to 2010. These patients were tracked for imaging obtained, and eventual development of subsequent associated spinal pathology diagnoses using CPT and ICD-9 codes for up to 1 year after initial presentation. Results: A total of 215,592 adolescents were identified presenting with low back pain (LBP) from 2007 to 2010. Over 80% of adolescents with LBP had no identifiable diagnosis within 1 year. The most common associated subsequent diagnoses were lumbar strain/spasm (8.9%), followed by scoliosis (4.7%), lumbar degenerative disk disease (1.7%), and lumbar disk herniation (1.3%). The rates of all other diagnoses including spondylolysis, spondylolisthesis, infection, tumor, and fracture had <1% association with LBP. Conclusions: In conclusion, adolescent LBP is a common diagnosis for which underlying serious pathology is rare. The most common diagnosis aside from strain or muscle spasm associated with LBP are scoliosis and degenerative disk disease. Pediatric orthopaedists often are consulted on patients with LBP and should always have high suspicion for potential serious spinal pathology, but should recognize the most common etiologies of back pain in adolescence. Level of Evidence: Level IV - case series.
AB - Background: Back pain in adolescents is very common and often seen in the office for evaluation of potential spinal pathology. Pediatric back pain has often thought to be from serious identifiable causes such as spondylolysis, spondylolisthesis, tumor, or infection. A follow-up analysis of adolescents initially presenting with back pain to their eventual subsequent diagnosis within 1 year has not been reported on a large scale with a national sample. Methods: A national insurance database (PearlDiver Patient Records Database) was queried for ICD-9 codes to identify patients aged 10 to 19 years with back pain from 2007 to 2010. These patients were tracked for imaging obtained, and eventual development of subsequent associated spinal pathology diagnoses using CPT and ICD-9 codes for up to 1 year after initial presentation. Results: A total of 215,592 adolescents were identified presenting with low back pain (LBP) from 2007 to 2010. Over 80% of adolescents with LBP had no identifiable diagnosis within 1 year. The most common associated subsequent diagnoses were lumbar strain/spasm (8.9%), followed by scoliosis (4.7%), lumbar degenerative disk disease (1.7%), and lumbar disk herniation (1.3%). The rates of all other diagnoses including spondylolysis, spondylolisthesis, infection, tumor, and fracture had <1% association with LBP. Conclusions: In conclusion, adolescent LBP is a common diagnosis for which underlying serious pathology is rare. The most common diagnosis aside from strain or muscle spasm associated with LBP are scoliosis and degenerative disk disease. Pediatric orthopaedists often are consulted on patients with LBP and should always have high suspicion for potential serious spinal pathology, but should recognize the most common etiologies of back pain in adolescence. Level of Evidence: Level IV - case series.
KW - low back pain
KW - scoliosis
KW - spondylolisthesis
KW - spondylolysis
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U2 - 10.1097/BPO.0000000000000653
DO - 10.1097/BPO.0000000000000653
M3 - Article
C2 - 26368854
AN - SCOPUS:84944339815
SN - 0271-6798
VL - 37
SP - 344
EP - 347
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
IS - 5
ER -