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(455) The clinical efficacy of repeat magnetic resonance imaging in patients with chronic spine pain

      The appropriate use of diagnostic imaging can improve the care of patients with chronic low back and neck pain; in stark contrast, the inappropriate use can increase harm to patients and healthcare costs. The rate of lumbar magnetic resonance imaging (MRI) has increased at an alarming rate without evidence of concomitant improvements in patient outcomes. In examining interval changes in MRIs of patients with chronic back and neck pain, this study strove to quantitate the efficacy of repeat imaging. Data on 89 consecutive patients with multiple lumbar and cervical MRI was collected from June 2015 to August 2015. Data assessed included gender, age, weight, BMI, diagnosis, MRI results, and surgical treatment post-imaging. Radiologic changes were defined as increases in severity of abnormality at a particular disk level by the radiologists of record. There were 58 (65.2%) females and 31 (34.8%) males of mean age 59.1 years, BMI 31.2. Out of 192 MRIs, 130 (67%)were lumbar and 62 (32.3%) cervical. 79 (60.8%) lumbar MRIs and 47 (75.8%) cervical MRIs did not show interval changes. Of MRIs with changes, 17 (34.6%) lumbar and 5 (33.4%) cervical with severe changes. The mean time in years between recent and previous MRI was 2.9 for severe changes and 2.0 for no changes on cervical MRI (p=0.215) and 2.6 for severe changes and 1.7 for no changes on lumbar MRI (p=0.018). 7 (11.5%) patients had surgery after cervical MRI and none after lumbar MRI. Significant number of repeat MRIs did not show interval changes or resulted in surgical treatment post-imaging. (Flynn et al., Journal of Orthopadic & Sport Physical Therapy, 2011; Tetsuo et al., J. Spinal Disorder Tech, 2005)