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Could Back MRI Lead to Unnecessary Surgery

May 13, 2017 - By Dr. Kristie

If you’re suffering from lower back pain and your doctor suggests an MRI of the back, don’t be too quick to make that appointment. A new report compiled by researchers at Stanford Medical Center shows that getting an MRI of the back could lead to unnecessary back surgery. Another disturbing finding. Doctors who practice in areas with a high density of MRI scanners are more likely to request an MRI of the back regardless of what they find on clinical exam.

An MRI of the back is safe since it doesn’t involve exposure to radiation, but it’s an expensive study and one that’s also quite sensitive. This means it can show abnormalities that aren’t clinically significant and that don’t require aggressive intervention such as surgery. According to the researchers, up to one in five MRI’s of the back will show an abnormality that could be falsely interpreted as significant. When doctors see these “false positives” on MRI; they’re more likely to refer a back pain sufferer to an orthopedist for surgical consideration.

The strange thing about an MRI of the back is that it can look relatively normal even in cases where a person is experiencing a great deal of back pain. It can also show apparent abnormalities when a person’s back pain is minimal. This is why the clinical history is so important when considering aggressive treatment like surgery. An MRI of the back is only one small piece of information in the bigger clinical picture.

The reality is that most back pain goes away over time with conservative treatment such as rest, anti-inflammatory medications, back and back strengthening exercises. Surgery of the back is not without risks and should be reserved for cases where less drastic measures aren’t effective. When surgery is done to relieve back problems, it isn’t always successful and there’s a risk of complications including blood clots, nerve injury, reactions to anesthesia, pneumonia, and even paralysis. Lumbar back surgery should never be done based on the results of a single MRI of the back. Most doctors like to reserve back surgery for situations where other treatments have failed.

Of course, there are serious causes of back pain - some of which are unrelated to the spine. Conditions such as kidney stones, cancer, heart disease, and abdominal aortic aneurysms are examples of non-spine related diseases that cause back pain. Most of these conditions can be diagnosed through history and a good clinical exam although further imaging may be needed in some cases. This is why it’s important that a doctor know about all symptoms - even ones that aren’t related to the back.

The bottom line? If a doctor recommends surgery based on the results of a single MRI of the back, get a second opinion.


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Note: Articles not intended to Diagnose, Treat, Cure or Prevent Diseases.