So concludes a new study in which 380 adult patients with low back pain in the Seattle area were randomly assigned to receive either conventional radiographs (X-rays) or rapid MRI to evaluate the cause of their discomfort.
Dr. Jeffrey G. Jarvik, associate professor of radiology and neurosurgery and a member of the Center for Cost and Outcomes Research at the University of Washington at Seattle and colleagues conducted the study. A report on their findings appears in the June 4 issue of the Journal of the American Medical Association.
In an accompanying editorial written at the journal's request, Dr. Nortin M. Hadler, professor of medicine at the University of North Carolina at Chapel Hill, wrote that rapid MRI is an adaptation of standard MRI, but provides adequate images more rapidly and at considerably less cost.
"The study shows that substituting rapid MRI neither saved money nor led to improved clinical outcomes," said Hadler, professor of medicine at the UNC School of Medicine. "Rather, the data suggest that substituting rapid MRI increases cost in part because it predisposes patients to undergo surgical interventions."
Hadler is a rheumatologist with research interest in back pain -- a nearly universal problem -- and other regional musculoskeletal ailments.
Twelve months after the tests, Jarvik and colleagues evaluated functional disability among 337 of the 380 back patients assigned to the two groups. They and found little differences in disability and no significant differences in pain intensity, pain frequency or in physical functioning.
"Ten patients in the rapid MRI group vs. four in the radiograph group had lumbar spine operati
Contact: David Williamson
University of North Carolina at Chapel Hill