原创力文档routine versus needs-based mri in patients with prolonged low back pain a comparison of duration of treatment, number of clinical contacts and referrals to surgery常规和以需求为基础的mri长期腰痛患者治疗时间的比较,临床联系和推荐手术的数量.pdfVIP
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routine versus needs-based mri in patients with prolonged low back pain a comparison of duration of treatment, number of clinical contacts and referrals to surgery常规和以需求为基础的mri长期腰痛患者治疗时间的比较,临床联系和推荐手术的数量
Jensen et al. Chiropractic Osteopathy 2010, 18:19
/content/18/1/19
RESEARCH Open Access
Routine versus needs-based MRI in patients with
prolonged low back pain: a comparison of
duration of treatment, number of clinical contacts
and referrals to surgery
Rikke K Jensen1,2*, Manniche Claus1,2, Charlotte Leboeuf-Yde1,2
Abstract
Background: The routine use of radiology is normally discouraged in patients with low back pain (LBP). Magnetic
Resonance Imaging (MRI) provides clinicians and patients with detailed knowledge of spinal structures and has no
known physical side effects. It is possible that insight into the pathological changes in LBP patients could affect
patient management. However, to our knowledge, this has never been tested. Until June 2006, all patients at our
specialised out-patient public clinic were referred for MRI on the basis of clinical indications, economic constraints,
and availability of MRI (the “needs-based MRI” group). As a new approach, we now refer all patients who meet
certain criteria for routine up-front MRI before the clinical examination (the “routine MRI” group).
Objectives: The aims of this study were to investigate if these two MRI approaches resulted in differences in: (1)
duration of treatment, (2) number of contacts with clinicians, and (3) referral for surgery.
Design: Comparison of two retrospective clinical cohorts.
Method: Files were retrieved from consecutive patients in both groups. Criteria for referral were: (1) LBP or leg
pain of at least 3 on an 11-point Numeric Rating Scale, (2) duration of present symptoms from 2 to12 months and
(3) age above 18 years. A comparison was made between the “needs-based MRI” and “routine MRI” groups on the
outcomes of duration of treatment and use of resources.
Results: In all, 169 “needs-based MRI” and 208 “routine MRI” patient fi
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