{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:02:09Z","timestamp":1787760129383,"version":"build-2784847793"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Sao Paulo Research Foundation","award":["2021\/14189-4"],"award-info":[{"award-number":["2021\/14189-4"]}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the prevalence of serious spinal pathologies and nonspinal conditions in people seeking care for low back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Literature searches were conducted in 6 electronic databases. Observational studies investigating the prevalence of serious spinal pathologies and nonspinal conditions in adults seeking health care for a complaint of low back pain were considered eligible. Risk of bias was assessed with a tool for prevalence studies. Meta-analyses using random effect models were conducted to obtain pooled prevalence estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven studies were included in this review; most (64%) were at low risk of bias. With moderate certainty of evidence, the pooled prevalence of serious spinal pathologies was 2.9% (95%\u00a0confidence interval: 1.6% to 5.2%) in people with a complaint of low back pain at presentation. The prevalence, however, varied by setting: primary care, 0.8%; emergency department, 2.1%; secondary care, 4.6%; and tertiary care, 6.9%. With moderate certainty of evidence, the prevalence of individual serious spinal pathologies ranged from 0.3% for cauda equina syndrome to 2.4% for spinal fracture. The prevalence of nonspinal conditions from Australian emergency department studies varied greatly, ranging from 21.5% to 58.3%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of serious spinal pathologies and nonspinal conditions varied greatly. Differential diagnostic strategies with clear care pathways need to be available to ensure a prompt diagnosis of serious spinal pathologies and nonspinal conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42022352568.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnaf078","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T07:56:50Z","timestamp":1750406210000},"page":"43-52","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence of serious spinal pathologies and nonspinal conditions in low back pain: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"27","author":[{"given":"Lorena S","family":"Reginato","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Western S\u00e3o Paulo (UNOESTE) , Presidente Prudente, 19050-920,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo C","family":"Machado","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney , Sydney, NSW 3150,","place":["Australia"]},{"name":"Institute for Musculoskeletal Health, Sydney Local Health District and University of Sydney , Sydney, NSW 3150,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris G","family":"Maher","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney , Sydney, NSW 3150,","place":["Australia"]},{"name":"Institute for Musculoskeletal Health, Sydney Local Health District and University of Sydney , Sydney, NSW 3150,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme H 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