Lumbar spine MRIs frequently ineffective — 6 insights


A retrospective cohort study in The Spine Journal found the proportion of lumbar spine MRIs that inform low back pain management is small.

Here are six things to know.

1. The study sampled 5,365 outpatient lumbar spine MR examinations to determine the proportion of examinations with a detectable impact on patient care — actionable outcomes.

2. Actionable outcomes included:

  • Findings leading to an intervention such as surgery
  • New diagnoses of cancer, infection or fracture
  • Following known lumbar spine pathology

3. The study authors assessed potential harm by identifying examinations where a suspicion of cancer or infection was raised, but no positive diagnosis was made.

4. The proportion of actionable lumbar spine MRIs was 13 percent; 93 percent were appropriate according to American College of Radiology guidelines.

5. The false positive rate and proportion of false positives followed by further investigation was high. Of 36 suspected cases of cancer or infection, 81 percent were false positives. Further investigations were ordered on 59 percent of suspicious exams, 86 percent of which were false positives.

6. The study authors highlight the need for more research on imaging efficacy.

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