Back off routine spinal imaging

A retrospective study by a spinal surgery unit has looked at referrals for lumbar problems. The Canadian researchers wanted to know if MRI helps identify patients who need surgery.

There were 2021 adults referred for surgical assessment of their symptoms. Information from MRI was available for 1586 cases. The MRI reports were reviewed for six types of abnormality at five points in the lumbosacral spine, including degenerative discs, disc herniation and spinal stenosis.

A single spinal surgeon assessed the patients: 690 were not suitable for surgery, and in 174 there was uncertainty. The surgeon found that 722 patients were candidates for surgical intervention. Of these, 411 eventually had surgery.

Surgical candidates were more likely to have spinal stenosis on MRI than other patients. Those with degenerative disc disease were less likely to be considered.

Multivariate analysis identified age, disk herniation, spinal