News | August 21, 2012

Early MRIs Don't Lead to Better Outcomes in Back Injury

Disability may even be prolonged with early scans, suggests study in Spine

August 21, 2012 — If you've recently hurt your back on the job, getting a magnetic resonance imaging (MRI) scan won't increase your chances of a good recovery, suggests a study in the August 15 issue of the journal Spine, published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

In fact, early MRI scanning as part of early assessment of back injuries may even be linked to prolonged disability, according to the study by Janessa M. Graves, MPH, Ph.D., and colleagues of University of Washington, Seattle.


Early MRI Scans Don't Improve Outcomes After Back Injury

Graves and colleagues analyzed Washington State workers’ compensation data on 1,226 workers with acute lower back injury. About 78 percent of the injured workers were classified as having mild to major sprains, while 22 percent had injury involving the spinal nerve roots (radiculopathy). About one out of five workers underwent MRI scanning within six weeks after injury. The researchers compared the final outcomes of lower back injury for workers with and without early MRI scans.

There were some differences between groups, including higher initial pain scores and lower functional scores for workers undergoing early MRI. After adjustment for these factors, patient outcomes one year after injury were not significantly different for workers who did and did not have early MRI scans. This was so for workers with both sprains and radiculopathy.

Among workers with sprains, those who underwent early MRI were twice as likely to be on work disability at one year. Disability rates were not significantly different for workers with radiculopathy. However, in both groups, workers with early MRI scanning had a longer duration of disability.

The use of MRI and other advanced diagnostic imaging tests has increased rapidly in recent years. Previous studies have suggested that using MRI scans in early evaluation of low back pain leads to increased use of health care services and increased costs, without improving patient outcomes.


'Cascade of Care' May Lead to Longer Disability

The new study supports this finding in a large sample of workers' compensation patients with back injury. The results show no evidence of improved outcomes for workers with this "common and costly" occupational injury. In addition, the results suggest that early MRI scans may even lead to increased disability.

"A 'cascade of care' may occur following early imaging in which conditions not attributable to the low back pain (and potentially asymptomatic) may be discovered and unnecessarily treated," wrote Graves and colleagues. This unnecessary testing and treatment may lead to "more time away from work and lost productivity."

The results add to evidence that MRI scanning is not useful or necessary in the routine evaluation of low back injuries. The authors acknowledge some important limitations of their study, including a lack of information on some factors that could potentially affect the use of early MRI or the final outcomes of back injury. "Future research should address this topic using a randomized controlled design, which could validate our findings," they concluded.

For more information: http://journals.lww.com/spinejournal/Fulltext/2012/08150/Early_Imaging_f...

Related Content

Philips Introduces Technology Maximizer Program for Imaging Equipment Upgrades
Technology | Imaging | January 17, 2018
January 17, 2018 — Philips recently announced the launch of Technology Maximizer, a cross-modality program designed t
Russian Team Developing New Technology to Significantly Reduce MRI Research Costs
News | Magnetic Resonance Imaging (MRI) | January 16, 2018
January 16, 2018 — Researchers from the NUST MISIS Engineering Center for Industrial Technologies in Russia have deve
Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Smartphone Addiction Creates Imbalance in Brain
News | Mobile Devices | January 11, 2018
Researchers have found an imbalance in the brain chemistry of young people addicted to smartphones and the internet,...
Minimally Invasive Treatment Provides Relief from Back Pain

Lumbar spine MRI showing disc herniation and nerve root at baseline and one month after treatment

News | Interventional Radiology | January 11, 2018
The majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back...
Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.

News | Clinical Study | January 11, 2018
January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opio
CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta.

News | Computed Tomography (CT) | January 11, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...
Study Finds No Evidence that Gadolinium Causes Neurologic Harm

MR images through, A, C, E, basal ganglia and, B, D, F, posterior fossa at level of dentate nucleus. Images are shown for, A, B, control group patient 4, and the, C, D, first and, E, F, last examinations performed in contrast group patient 13. Regions of interest used in quantification of signal intensity are shown as dashed lines for globus pallidus (green), thalamus (blue), dentate nucleus (yellow), and pons (red).

News | Contrast Media | January 11, 2018
January 11, 2018 — There is no evidence that accumulation in the brain of the element gadolinium speeds cognitive dec

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
Overlay Init