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27.12.2017 | Review Article

The Global Spine Care Initiative: a systematic review of individual and community-based burden of spinal disorders in rural populations in low- and middle-income communities

verfasst von: Eric L. Hurwitz, Kristi Randhawa, Paola Torres, Hainan Yu, Leslie Verville, Jan Hartvigsen, Pierre Côté, Scott Haldeman

Erschienen in: European Spine Journal | Sonderheft 6/2018

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Abstract

Purpose

The purpose of this review was to synthesize literature on the burden of spinal disorders in rural communities to inform the Global Spine Care Initiative care pathway and model of care for their application in medically underserved areas and low- and middle-income countries.

Methods

A systematic review was conducted. Inclusion criteria included all age groups with nonspecific low back pain, neck pain, and associated disorders, nonspecific thoracic spinal pain, musculoskeletal chest pain, radiculopathy, or spinal stenosis. Study designs included observational study design (case-control, cross-sectional, cohort, ecologic, qualitative) or review or meta-analysis. After study selection, studies with low or moderate risk of bias were qualitatively synthesized.

Results

Of 1150 potentially relevant articles, 43 were eligible and included in the review. All 10 low and 18 moderate risk of bias studies were cross-sectional, 14 of which included rural residents only. All studies included estimates of low back pain prevalence, one included neck pain and one reported estimates for spinal disorders other than back or neck pain. The prevalence of low back pain appears greater among females and in those with less education, psychological factors (stress, anxiety, depression), and alcohol consumers. The literature is inconsistent as to whether back pain is more common in rural or urban areas. High risk of bias in many studies, lack of data on disability and other burden measures and few studies on conditions other than back and neck pain preclude a more comprehensive assessment of the individual and community-based burden of spinal disorders in less-developed communities.

Conclusion

We identified few high-quality studies that may inform patients, providers, policymakers, and other stakeholders about spinal disorders and their burden on individuals and communities in most rural places of the developing world. These findings should be a call to action to devote resources for high-quality research to fill these knowledge gaps in medically underserved areas and low and middle-income countries.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Titel: The Global Spine Care Initiative: a systematic review of individual and community-based burden of spinal disorders in rural populations in low- and middle-income communities
verfasst von: Eric L. Hurwitz
Kristi Randhawa
Paola Torres
Hainan Yu
Leslie Verville
Jan Hartvigsen
Pierre Côté
Scott Haldeman
Publikationsdatum: 27.12.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe Sonderheft 6/2018
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-5393-z

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