A retrospective review of mri results for low backache: Are we over investigating?
Khanduja S, Loomba V, Sibai N, Upadhyay A. A retrospective review of mri results for low backache: Are we over investigating?. Pain Medicine 2017; 18(3):602-603.
Introduction: Back pain is a worldwide health problem. 1 MRI is a common modality for diagnosing back and leg pain. There are specific guidelines for use MRI. However, the use of MRI as the initial imaging for low back pain seems to be more common in general practice. Materials and Methods: We did a retrospective chart review of about 300 patients over a 3-year period who had undergone MRI of lumbosacral spine. We recorded and compared various factors including age, sex, BMI, current smoking history, race, symptoms, MRI findings, and progression to surgery within the next year. All rates were compared between groups using chi-square or Fisher's exact tests (if expected cell counts are <5). All analyses were performed using SAS 9.4. Results: There are no statistically significant differences in the rates of each symptom between the two groups (MRI positive and negative). About 58% of the MRI results showed radiographically significant findings. One hundred and thirty (41.5%) of the MRIs were negative. The difference in rates of surgery in the next year (33/183 (19.0%) among positive MRI patients and 11/130 (8.5%) among MRInegative patients) is statistically significant at p=0.010. Conclusions: 41.5% of patients underwent lumbar MRI unnecessarily! 81% of patients with positive MRIs did not have surgery. More physician training is needed to avoid unnecessary investigations and expenditure.