More MRIs Lead to More Back Surgery

[BP4MS]

According to research from Stanford University School of Medicine, published in Health Affairs, the more MRI machines in a given area the more likely that patients will have an early MRI. And the high availability of MRI machines in an area also means more back surgery. The researchers looked at Medicare data from 1998-2005, and found that patients with new pain in their lower back were more likely to have surgery if they were in an area that had a higher than average number of MRI machines.

"Not only are patients in high-availability areas getting more MRIs, but they are getting them earlier," said study first author Jacqueline Baras, a Stanford University medical student.

"The worry is that many people will not benefit from surgery, so heading in this direction is concerning," said senior author Laurence Baker, a professor of health research and policy.

Earlier research has found that increased surgery rates don't improve outcomes for patients with new-onset low back pain.

[admin]

The same conclusion was presented in June 2009 at Forum X of Primary Care Research On Low Back Pain . The paper presenters Barbara Webster, Manuel Cifuentes, Glenn Pransky concluded:

- Not ordering an MRI was associated with much lower surgery utilization and time on disability
- Ordering an early MRI increased surgery utilization but not disability duration

[admin]

On a similar theme, the Independent newspaper in the UK comments on back treatment changes in the UK National Health Service, with a note:

"Evidence shows that ordering X-rays can make patients worse, by confirming their invalid status. "

At the bottom of the article it says:

"X-rays and MRI scans They are often ordered but are of little use, and may make the patient worse. MRI scans should only be used where the patient is being referred for surgery."

[Leeann]

How do they know the patient needs surgery without the MRI? This is confusing. However, I agree that spinal surgery has increased dramatically. Whether it is the fault of MRI's or not is debatable. I prefer to blame the surgeons, who should KNOW that the patient will not do ANY BETTER with or without surgery - and who should recommend conservative care, i.e. physical therapy, etc. Afterall, the neurosurgeon still has brains to operate on! LOL.

[Craftweb]

The disadvantage is the results of an MRI may create a false positive. This means the MRI revealed a disorder for which there are no corresponding clinical symptoms. The point is this - the clinical symptoms must coincide with test results. It is not uncommon for a patient to come to the physician with a stack of MRIs indicating a herniated disc.