June 3, 2003
UW study shows MRIs have no advantage over traditional radiography in diagnosis and treatment of low back pain
A University of Washington study featured in this week’s issue of the Journal of the American Medical Association shows that while the latest technology may be faster than traditional radiograph or X-ray in providing images of the spine, rapid magnetic resonance imaging, or rapid MRI, does not result in cost savings or significant reductions in lower back pain.
In a randomized controlled trial designed by Dr. Jeffrey Jarvik, associate professor of both radiology and neurosurgery in the UW School of Medicine, and colleagues, 380 patients at the UW and three private clinics in the Seattle area were enrolled when their physicians ordered radiographs of the lumbar spine. The patients were randomly assigned to receive either a rapid MRI or a radiograph. Then 337 of the participants were assessed for functional disability, pain and satisfaction with treatment a year later.
“There were no significant differences in back-related disabilities between the two groups,” Jarvik said. “There were no significant differences either in how bothersome the patients found their back pain, how frequently it recurred or physical function.”
Use of the rapid MRI was associated with more lower back surgeries and thus greater expense than the radiograph technique.
“Although doctors and patients prefered the MRI, we advocate caution in substituting rapid MRI for radiographs in primary care,” Jarvik said. “Use of MRIs may result in more back surgeries without any significant difference in outcome and slightly higher expense than the traditional radiograph.”
This study was supported by grants from the Agency for Health Care Research and Quality and the National Institute for Arthritis and Musculoskeletal and Skin Diseases.
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