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Low Back Pain Emergencies

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Emergency Neurology

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Abstract

Low back pain is exceedingly common. Most patients with low back pain present acutely or subacutely. The clinician is frequently faced with the task of determining whether or not the individual low back pain patient has an emergent or unstable underlying condition. The approach to the patient with acute or subacute low back pain includes a search for red flags 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 flags, patients can be treated conservatively for 1 month or more without diagnostic testing.

Patients who have or develop red flags should undergo urgent and sometimes emergent investigation. Low back pain emergencies include infections (vertebral osteomyelitis and/or epidural abscess), primary and metastatic spine tumors, thoracic aortic dissection, expansion or rupture of an abdominal aortic aneurysm, a large lumbar disc protrusion or extrusion with compression of the cauda equina, and thoracolumbar fractures.

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Author information

Authors and Affiliations

  1. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA

    Chris Marcellino

  2. Department of Neurology, Mayo Clinic, Rochester, MN, USA

    Chris Marcellino

  3. Department of Neurology, Mayo Clinic, Rochester, MN, USA

    Alejandro A. Rabinstein & J. D. Bartleson Jr.

  4. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Greta B. Liebo & Timothy P. Maus

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  1. Chris Marcellino
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  2. Alejandro A. Rabinstein
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  3. Greta B. Liebo
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  4. Timothy P. Maus
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  5. J. D. Bartleson Jr.
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Correspondence to Chris Marcellino .

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Editors and Affiliations

  1. The John and Nancy Nelson Professor of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA

    Karen L. Roos

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Marcellino, C., Rabinstein, A.A., Liebo, G.B., Maus, T.P., Bartleson, J.D. (2021). Low Back Pain Emergencies. In: Roos, K.L. (eds) Emergency Neurology. Springer, Cham. https://doi.org/10.1007/978-3-030-75778-6_2

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