Evidence map›Paper›PMID 30531654›Full record

ArticleNeurospine2018

Retrospective Review of Magnetic Resonance Imaging of the Lumbosacral Spine: Are We Overinvestigating?

Suchit Khanduja, Vivek Loomba, Joseph Salama-Hannah, Aman Upadhyay, Neha Khanduja, Gaurav Chauhan

Abstract read
In one paragraph

Article in Neurospine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Suchit KhandujaDepartment of Anesthesiology, Henry Ford Hospital, Detroit, MI, USA.
Vivek LoombaDepartment of Anesthesiology, Henry Ford Hospital, Detroit, MI, USA.
Joseph Salama-HannahDepartment of Anesthesiology, Henry Ford Hospital, Detroit, MI, USA.
Aman UpadhyayDepartment of Anesthesiology, Henry Ford Hospital, Detroit, MI, USA.
Neha KhandujaDepartment of Anesthesiology, Henry Ford Hospital, Detroit, MI, USA.
Gaurav ChauhanDepartment of Anesthesiology, Henry Ford Hospital, Detroit, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveLower back pain (LBP) is a worldwide health problem, and magnetic resonance imaging (MRI) is a common modality used to aid in its diagnosis. Although specific guidelines for assessing the necessity of MRI usage exist, the use of MRI as the initial imaging method for LBP seems to be more common than necessary in general practice.

methodsWe conducted a retrospective chart review of 313 patients who had undergone MRI of the lumbosacral spine during 2014-2015. We recorded and compared various factors, including age, sex, body mass index, current smoking status, race, symptoms, MRI findings, and progression to surgery within the next year. All rates were compared according to whether the MRI results showed radiographically significant findings (MRI-positive) or not (MRI-negative) using the chi-square or Fisher exact tests (if the expected cell count was <5). All analyses were performed using SAS version 9.4.

resultsThere were no statistically significant differences in the rates of each symptom between the MRI-positive and MRI-negative groups, which accounted for 58.5% (183 of 313) and 41.5% (130 of 313) of the MRIs, respectively. The difference in the rate of surgery in the next year (18% among MRI-positive patients and 8.5% among MRI-negative patients) was found to be statistically significant (p<0.05).

conclusionBased on our findings, 41.5% of patients underwent lumbar MRI unnecessarily and 81% of patients with positive MRIs did not have surgery within the next year. Further physician training is needed to avoid unnecessary investigations and expenditures.

Indexed as

Lower back painLumbar magnetic resonance imagingSpinal surgery

Identifiers

PMID30531654
PMCPMC6347347

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.