Acute LBP...Is MRI Beneficial or Actually Harmful?
Reference:Modic MT, et al. Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome. Radiology. 2005 Nov;237(2):597-604
This extremely important study randomly provided 246 patients with acute-onset LBP or radiculopathy with MRI, then randomly allocated them into two groups.
Group #1: The patients and the physicians were provided with the MRI results
Group #2: Both patients and physicians were blinded to MRI results
All the patients underwent 6 weeks of conservative care.
Result #1: Disc herniations were identified on MRI in 60% of patients.
Result #2: There was no relationship between the type or the size of the herniation and clinical outcomes.
Result #3: Ironically, after 6-weeks of conservative intervention, the patients WITH disc herniations had BETTER functional scores compared to those without disc herniations (P = .003).
Result #4: The patients who were NOT informed of their MRI results had significantly better “general health / self well-being” scores than those who had been informed of their MRI results.
Clinical Relevance: When it comes to acute LBP (without ‘red flags’), costly MRIs are neither beneficial nor do they predict patient outcomes. On the contrary, patients? knowledge of their MRI, CT scan or x-ray results may be directly linked to a “lesser sense of well-being”, with increased potential risk of chronicity!
Posted on: November 22, 2006
Categories: Lumbar Spine