No abstract

Introduction: Lower back pain is one of the most common symptoms in patients referred to emergency department. Physicians should always keep in mind avoiding unnecessary radiographs for patients. On the other hand, the specificity and sensitivity of midline tenderness for lumbosacral spinal fracture and injury following analgesic analgesia is uncertain, therefore, this study investigated the effect of intravenous acetaminophen in reducing the need for radiography in patients referred to the emergency department with lumbosacral trauma. Materials and Methods: All patients with lumbosacral trauma referred to the emergency department, who had midline tenderness, were evaluated for the first 6 months from September 2017 until the end of March 2018. For these patients, acetaminophen at a dose of 15 mg/kg was given intravenously. Then, lumbosacral area CT imaging was performed by radiology technician. Furthermore, 60 minutes after intravenous acetaminophen, patients were again examined for lumbosacral midline tenderness and the results were compared with imaging. Data were analyzed by SPSS-17 software. Results: 421 patients suffering from blunt lumbar trauma with midline tenderness were enrolled. Mean age of patients was determined to be 34.27 (SD: 9.25). In terms of gender, 284 (67.5%) patients were male and 137 (32.5%) were female. The sensitivity and specificity for midline tenderness after intravenous acetaminophen were 71.43% and 96.97%, respectively. Moreover, positive and negative predictive values were reported as 83.33% and 94.12%, respectively. Conclusion:The results of the present study indicate that the presence of midline tenderness in the lumbosacral area after receiving intravenous acetaminophen in patients with lumbosacral trauma is highly suggestive of fracture and tenderness elimination largely denies the existence of fractures, but these findings are not conclusive.