&lt;p&gt;The Yield of Lumbosacral Spine MRI in Patients with Isolated Chronic Low Back Pain: A Cross-Sectional Study&lt;/p&gt;

Kanaan, Tareq; Alisi, Mohammed S; Anasweh, Yara; Yousef, Noor; Al-Sabbagh, Qussay; Hadidi, Fadi; Al-Shudifat, Abdul Rahman

doi:10.2147/orr.s265905

Cited by 1 publication

(2 citation statements)

References 18 publications

(11 reference statements)

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“…In our study, most patients who had positive MRI findings underwent conservative management (88%), which means that the MRI did not change the management plan. According to Kanaan et al, multiple randomized clinical trials have shown that early imaging versus conservative treatment without imaging for patients with no red flags does not enhance patient outcomes [15]. Moreover, a 2020 study of 405,965 United States primary care patients found that those who had early MRI were more likely to undergo back surgery (1.48% versus 0.12%) and take prescription opioids (35.1% versus 28.6%), yet they had a higher pain score at one-year follow-up (3.99 versus 3.87) than those who did not get early MRI [21].…”

Section: Discussionmentioning

confidence: 99%

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The Utilization of Lumbar MRI for Lower Back Pain at National Guard Hospital, Jeddah: A Retrospective Cohort Study

Babateen¹,

Alharbi²,

Alnejadi³

et al. 2022

Cureus

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IntroductionMagnetic reasoning imaging (MRI) is the imaging modality of choice for detecting spinal pathologies. The study of the appropriateness of MRI utilization in Saudi Arabia is lacking. As a result, this research aims to assess the use and misuse of lumbar MRI in lower back pain (LBP) at the National Guard Hospital (NGH) in Jeddah city. MethodsThis is a retrospective cohort study that included all adult patients who had lumbar MRI for LBP at NGH in 2019. A total of 1,225 patients were included. Patients with extreme ages, trauma, recent lumbar spine surgery, spine or spinal canal tumors, and infection were excluded, leaving a number of 805 patients. Specific MRI findings were obtained and assessed in association with history and physical examination. ResultsLBP with radiculopathy was the most common complaint (82.9%) followed by LBP without radiculopathy (12.8%), with the lowest being limb pain alone (2.6%). Overall, 72% of patients had negative MRI findings, which did not explain their symptoms, and 28% had positive MRI findings that were not associated with their symptoms (p < 0.001). A complete physical examination was performed on 27.5% of patients, of which only 12% had positive findings. MRI was ordered for 72.5% of patients without a complete physical examination. Finally, 88.2% of patients who had MRI were managed conservatively, while only 6.7% were managed with surgery (p < 0.04). ConclusionThe number of patients who had proper assessment prior to the ordering of MRI was significantly low. The decision to request MRI was not based on any scientific basis. This study has demonstrated that without proper and strict guidelines, MRIs will continue to be overutilized, which, in turn, will have negative consequences on the waiting time for an MRI and the cost of all the unnecessary MRIs. Furthermore, a good number of patients nowadays who do not have any indications for an MRI keep asking their physicians for it, and if the physician refuses, they transfer to another physician who will order the MRI.

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Section: Discussionmentioning

confidence: 99%

“…Anxious patients looking for a definitive diagnosis are a major cause of the inappropriate use of imaging [15]. In a survey, 50% of patients believed that everyone with LBP should have imaging, and 72% considered imaging as important [16].…”

Section: Introductionmentioning

confidence: 99%