DIAGNOSTIC-ACCURACY OF TECHNOLOGIES USED IN LOW-BACK-PAIN ASSESSMENT - THERMOGRAPHY, TRIAXIAL DYNAMOMETRY, SPINOSCOPY, AND CLINICAL EXAMINATION

Study Design. A prospective blind study compared three new technologie s to assess back pain. Objective. To assess the diagnostic accuracy an d comparability of thermography, triaxial dynamometry, and spinoscopy in the assessment of recent onset work-related low back pain. Summary of Background Data. The role of these technologies in assessing patien ts with low back pain is unproved. Methods. Forty-one patients with lo w back pain and 46 control subjects were assessed by each technology a nd by two clinical examiners blind to clinical status. Twenty patients were trained to simulate a healthy back without low back pain, and 50 % of the control subjects were trained to simulate the presence of a l ow back pain disorder. Each technology was interpreted on two occasion s by each of two readers. Results. Thermography performed significantl y worse than did triaxial dynamometry, spinoscopy, and clinical examin ation. The diagnostic accuracy of the last three was similar, and inte r-rater comparability did not differ significantly. Among simulators, the diagnostic accuracy of triaxial dynamometry and spinoscopy was sig nificantly higher than that of clinical examination, although consider able inaccuracy remained in assessing individual subjects. Conclusions . The diagnostic accuracy of thermography in recent onset low back pai n does not support its use. Among those simulating normality or low ba ck pain, triaxial dynamometry and spinoscopy have greater diagnostic a ccuracy than does a single clinical evaluation. However, for an indivi dual, the inaccuracy that remains limits the use of triaxial dynamomet ry or spinoscopy for diagnosis in recent onset low back pain.