New research from Johns Hopkins University found routine MRI imaging does not improve treatment and does not play a role in a physician's decision to give epidural steroid injections, the most common procedure performed at pain clinics in the U.S., according to a university news release.
Study leader Steven P. Cohen, MD, an associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, and his colleagues treated 132 patients for sciatica, a condition where the roots of the sciatic nerve are pinched or compressed, causing pain and tingling in the lower back and leg. The patients were split into two groups. Both groups received MRIs, but the physicians only reviewed the MRI in the second group. In the first group, injections were given based on physical examination and the patients' descriptions of their pain. In the second group, injections were given based on physical examination and MRI results.
After three months, the percentage of patients reporting successful treatment was not statistically different, at 35 percent in the first group and 41 percent in the second group. An independent evaluator agreed with the treatment of the physicians who did not review MRI results in 66 percent of the cases. In the second group, physicians only chose not to give injections in five cases, and three patients went on to have them anyway.
"Our results suggest that MRI is unlikely to avert a procedure, diminish complications or improve outcomes," Dr. Cohen said in the release. "Considering how frequently these epidural injections are performed, not routinely ordering an MRI before giving one may save significant time and resources."
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After three months, the percentage of patients reporting successful treatment was not statistically different, at 35 percent in the first group and 41 percent in the second group. An independent evaluator agreed with the treatment of the physicians who did not review MRI results in 66 percent of the cases. In the second group, physicians only chose not to give injections in five cases, and three patients went on to have them anyway.
"Our results suggest that MRI is unlikely to avert a procedure, diminish complications or improve outcomes," Dr. Cohen said in the release. "Considering how frequently these epidural injections are performed, not routinely ordering an MRI before giving one may save significant time and resources."
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Researchers Attempt to Find a Way to Block the Transmission of Pain Signals
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