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For Back Pain, MRI Often First Step Toward Useless Surgery

October 14, 2009 6:01 pm 9 comments

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Should we worry that a new Stanford study shows that those areas of the country that have the highest number of MRIs also have the highest incidence of surgery
for lower-back pain, despite the lack of evidence showing that the
surgeries are beneficial. The Los Angeles Times seems to think so. The paper reports of the research, which used Medicare claim data from 1998 to 2005 for patients with
non-specific low-back pain and compared it with data on the
availability of MRI scanners. The researchers
found that the number of scans for low-back pain and the number of
resulting surgeries in each of the 318 Metropolitan Statistical Areas
were directly proportional to the availability of scanners. About
two-thirds of the scans, moreover, occurred in the first month after
the onset of pain, despite clinical guidelines that recommend at least
a one-month delay because of the large number of patients who
spontaneously recover. Wait there's more: the paper reports that a single low-back scan can cost $1,500.

Read more in the L.A. Times.

9 Comments

  • barry callahan
    October 14, 2009
    6:39 pm

    This is exactly what Orthopaedic Surgeons have been saying for years (and yes I am one) but guess what, patients complain and demand an MRI because they want it despite our advice. So who’s to blame for useless studies…

    Reply
  • Dave Burnham
    October 14, 2009
    10:58 pm

    This is amazing——I have been going through severe back pain for about 6 weeks now. I have a history of back pain, resulting in three surgeries; cervical disc ruptured and two lumbar discs ruptured.
    I have had three injections, two upper back, and one lower back. the pain is still severe. Now I have resorted to electrical stimulus.
    The next step is on to the nerosurgeon. I can just hear him now. I just hope medical technology has allowed for more less avasive procedures.

    Reply
  • Tony Carpenter
    October 15, 2009
    11:30 am

    At first I thought my Lumbar fusion was the greatest thing since slice bread. I gained feeling in my legs that I havent felt in a long time. But two years later its all coming back but worse than before surgery. Why is that? Do I need more surgery? I will not go thru that again. The pain from surgery felt like a Mac Truck pushing me to a wall. Maybe I will wait until better technology comes out so the surgery will not cost and feel so bad.

    Reply
  • DB
    October 15, 2009
    4:22 pm

    I have a severely herniated disk at L4/5 and bulging disks at L3/L4 and L5/S1. Kettlebell and circuit training as well as yoga help me build core strength in the transverse abdominus. I am not pain free by any means but I can manage the condition. Spine specialist told me to skip surgery and learn to manage it, best medical advice I have ever gotten.

    Reply
  • Bob
    October 16, 2009
    7:48 am

    I believe this is another attempt to use “evidence” to limit medical expenses. I suffered from periodic back pain for many years and finally contacted a neurosurgeon who said “lets do a MRI” which revealed a severly damaged disk. The resulting surgery more than twenty years ago was very successful. We, as a nation, should capitalize on the latest imaging and medical techniques to assist in diagnosis and treatment of medical problems.

    Reply
  • Jorge Lopez
    October 23, 2009
    2:43 pm

    I have had low back pain since an accident at my work place for almost four years and I been under medical treatment with medications and MRI including EMG; but they haven’t find nothing and gave me an unclear diagnosis which make my situation and physical condition worst, among the others because I’m loosing motion and have difficulties to performance tasks. I hope there is an answer to all these questions and someone can help Me. I will appreciate it so much.
    Jorge.

    Reply
  • glucosamine
    October 24, 2009
    7:26 am

    Back pain is one of the most debilitating and chronic ailments affecting 8 out of 10 individuals at some point in their lives. Back pain is not a disease, but is a symptom occurring from variety of different conditions and processes. Most of the back pain causes are combination of muscle strain, overuse and injury. The back provides the movement, structural support and protection to certain body tissues

    Reply
  • Bob
    October 24, 2009
    8:40 pm

    You are well advised to avoid further surgeries, I have had 3 spinal fusions and am avoiding a fourth. It seems as though all my surgeries so far have resulted in aggravating weekness somwhere else in my spine. It is a vicious circle.

    Reply
  • axon
    November 7, 2009
    7:50 pm

    I wholeheartedly agree with the study/ evidence of the poor outcomes and futility of back surgery for the most part. My dad has had 3 spinal surgeries and he still has so much pain that he has to have a pain pump implanted into him to continuously deliver strong medication to the spine. Stick with exercise, good biomechanics , yoga, and chiropractic.

    Reply

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