Table 3.
Factors associated with the spinal pathologies featured in the Bayesian network (BN) as taken from Finucane et al [22] (cauda equina syndrome, spinal infection, fracture, and malignancy), McCrum [23] (inflammatory condition), and National Institute for Health and Care Excellence (NICE) guideline 59 [24] (nerve root condition).
Factors associated with spinal pathology | Contained in BN | ||
Cauda equina syndrome [22] | |||
|
Unilateral radicular pain |
|
|
|
Bilateral radicular pain | ✓ | |
|
Dermatomal reduced sensation |
|
|
|
Myotomal weakness | ✓ | |
|
Changes to bladder function | ✓ | |
|
Changes to bowl function | ✓ | |
|
Saddle sensory disturbance | ✓ | |
Malignancy [22] | |||
|
History of cancer | ✓ | |
|
Night pain |
|
|
|
Requiring strong pain killers | ✓ | |
|
Weight loss | ✓ | |
|
Balance issues |
|
|
|
Odd sensations in legs | ✓ | |
Fracture [22] | |||
|
History of cancer |
|
|
|
Multiple myeloma |
|
|
|
Osteoporosis | ✓ | |
|
Severe pain or worsening pain |
|
|
|
Age | ✓ | |
|
Sex |
|
|
|
Smoker |
|
|
|
Pain worse when lying supine |
|
|
|
Early menopause or late menarche |
|
|
|
History of fracture |
|
|
Spinal infection [22] | |||
|
Immunosuppression | ✓ | |
|
Steroid use | ✓ | |
|
Smoking |
|
|
|
Obesity |
|
|
|
History of TBa | ✓ | |
|
Fever | ✓ | |
|
Neurological dysfunction | ✓ | |
|
User of intravenous drugs | ✓ | |
|
Night pain | ✓ | |
Inflammatory condition [23] | |||
|
Age | ✓ | |
|
Waking at night |
|
|
|
Improvement with movement |
|
|
|
Improvement with NSAIDsb |
|
|
|
Past enthesitis, psoriasis, or arthritis | ✓ | |
|
Family history |
|
|
|
Uveitis | ✓ | |
|
Inflammatory bowel disease | ✓ | |
Nerve root condition [24] | |||
|
Unilateral leg pain |
|
|
|
Dermatomal changes |
|
|
|
Myotomal weakness | ✓ | |
|
Straight leg raise test positive |
|
|
|
Age |
|
|
|
Smoking |
|
|
|
Obesity |
|
aTB: tuberculosis.
bNSAID: nonsteroidal anti-inflammatory drug.