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Study: No difference in outcome found in lower back pain after early MRI scan

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Patients who undergo an early MRI scan for lower back pain do not have better health outcomes than patients who undergo delayed imaging, according to a recent study published in Spine.

Of 1,226 patients examined at 1-year follow-up, 18.6% underwent an MRI scan within 6 weeks of injury for lower back-related problems. After examining SF-36, Roland disability and pain intensity scores, researchers concluded that the early MRI scan was not associated with a better outcome and actually resulted in longer disability duration for patients with mild or major sprains, according to the study. However, all patients who underwent an MRI scan before 6 weeks took longer to return to work from disability than patients who received an MRI after 6 weeks.

Janessa M. Graves, MPH, PhD, and colleagues at the University of Washington suggested early MRI scans as part of routine care could lead to finding other asymptomatic conditions, which would increase the duration of disability, according to a press release.

“It may be possible that early diagnostic imaging triggers a ‘cascade of care’ effect: subsequent procedures and other health care activities that, while not associated with better health outcomes at 1 year, may result in more time away from work and lost productivity,” Graves stated in the study.

The most common form of injury was a mild or major sprain, which was reported in 77.9% of cases, followed by radiculopathy in 22.1% of cases. Patients with radiculopathy were significantly more likely to receive an early MRI than patients with mild or major sprains.

Reference:

Graves JM, Fulton-Kehoe D, Jarvik JG, Franklin GM. Early imaging for acute low back pain: One-year health and disability outcomes among Washington State workers. Spine. 2012; 37(18):1617-1627. doi:10.1097/BRS.0b013e318251887b.