Evaluation of a Systematic Approach to Pediatric Back Pain

Ramírez, Norman; Flynn, John M.; Hill, Brian W.; Serrano, Jose A.; Calvo, Carlos E.; R, Bredy; Macchiavelli, Raúl

doi:10.1097/bpo.0000000000000190

Cited by 38 publications

(37 citation statements)

References 22 publications

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“…Furthermore, the clinical significance of this information cannot be underestimated; the evaluation of adult patients with LBP must consider the well-documented presence of degenerative findings in asymptomatic subjects because the presence of degenerative changes may be only coincidental and may not be related to the symptoms. LBP in childhood and adolescence is not infrequent [4][5][6][7][8][9][10][11], and many pediatric patients with LBP undergo detailed investigations because it is usually considered that a high percentage of such patients will have a significant spinal disorder [27]; therefore, it is extremely important to determine that the actual prevalence of incidental findings in children is very low. Hence, we believe that our data will provide clinicians with better tools to weigh the importance of degenerative changes in the lumbar spine in their pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool

2015

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Section: Discussionmentioning

confidence: 99%

The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool

2015

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“…3,7,14 The referenced studies relate to establishing an algorithm for the treatment of LBP/AIS and were performed and published with the goal of educating the pediatrics community regarding the best way to efficiently evaluate LBP/AIS in children. All of these articles were published more than 5 years prior to the current data query.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 LBP evaluation and treatment algorithms provide a guide for physicians when ordering radiographs and MRI for LBP. 3,7,8 Within these studies for AIS and LBP, however, the authors acknowledge the significant rate of MRIs which yield relatively little diagnostic information. The workup of AIS and LBP can, at times, place undue burden on the patient, patient families, and the overall health care system.…”

Section: Introductionmentioning

confidence: 99%

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The Use of Magnetic Resonance Imaging and Plain Radiographs Among Adolescents With Back Pain and Adolescent Idiopathic Scoliosis

et al. 2018

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Background: Low back pain (LBP) and adolescent idiopathic scoliosis (AIS) are common pediatric diagnoses. The workup for these diagnoses can be highly variable and can use significant health care resources. There has been no analysis to date on the use of imaging for workup of AIS and/or LBP.Methods: The Humana Private Payer Database was queried for clinical and financial information for patients with AIS and/or LBP using International Classification of Diseases (ICD-9) for LBP and AIS. Current procedural terminology codes related to magnetic resonance imaging (MRI) and radiographs for the thoracolumbar spine were used to identify patients with LBP and/or AIS that used these diagnostic imaging modalities. Only patients ages 10 to 19 years were included in this analysis.Results: The total number of patients with AIS and LBP was 18 696 and 56 560, respectively. Thoracolumbar imaging was used within the workup for 71.76% and 45.53% of patients with AIS alone and LBP alone, respectively. MRI was used for 2.92% and 9.53% of patients with AIS alone and LBP alone, respectively. Radiographic imaging was used for 71.06% and 42.63% for AIS alone and LBP alone, respectively. There was minimal variation among regions in use of MRI for AIS. For patients with LBP, the diagnosis with the highest use of MRI was ''sciatica'' (29.07%). Patients with both LBP and AIS had statistically higher rates of imaging (91.04%), MRI (18.99%), and radiographs (89.71%). Among patients with an MRI, 20.87% never had a radiograph. Reimbursement per patient for radiographs was $164 and $239 for AIS and LBP, respectively. Reimbursement per patient for MRI was $1,263 and $1,882 for AIS and LBP, respectively.Conclusions: There is substantial use of both MRI and radiographs for adolescents with LBP and/or AIS. Clinicians should be aware of the impact these diagnostic tests have on the patient and the overall health care system.

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“…In children with back pain, algorithms have been developed to avoid unnecessary radiation exposure (4,5). As with adults, non-specific pain is the most common cause of back pain.…”

Section: General Indications For Spine Radiographsmentioning

confidence: 99%

The role of radiography in the study of spinal disorders

Santiago¹,

Ramos‐Bossini²,

Wáng³

et al. 2020

Quant Imaging Med Surg

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Despite the growing use of computed tomography (CT) and magnetic resonance imaging (MRI) in the study of spinal disorders, radiography still plays an important role in many conditions affecting the spine. However, the study and interpretation of spine radiograph is receiving less attention and radiologists are increasingly unfamiliar with the typical findings in normal and pathologic conditions of the spine. The aim of this article is to review the radiologic indications of radiograph in different pathologic conditions that affect the spine, including congenital, traumatic, degenerative, inflammatory, infectious and tumour disorders, as well as their main radiographic manifestations.

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Evaluation of a Systematic Approach to Pediatric Back Pain

Abstract: Level III.

Cited by 38 publications

References 22 publications

The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool

The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool

The Use of Magnetic Resonance Imaging and Plain Radiographs Among Adolescents With Back Pain and Adolescent Idiopathic Scoliosis

The role of radiography in the study of spinal disorders

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