The researchers analysed 468 MRI scans from 209 patients with chronic low back pain who had undergone at least two lumbar MRI examinations within a period of no more than two years. The aim was to investigate how much the condition of the spine changes on imaging over time and whether repeat scans influence clinical management.
The results showed that 40% of patients exhibited no changes in MRI findings. In nearly 90% of comparisons, the differences between the initial and follow-up scans were either non-existent or very small. Only degenerative changes in the spine’s facet joints showed a statistically significant progression during the study period.
The study also found that repeat MRI scans rarely resulted in changes to treatment plans. For approximately 45% of patients, the treatment strategy remained unchanged after a new MRI scan, and only about 12% were subsequently evaluated for surgical treatment. The researchers found no significant difference in the number of surgical recommendations made after the initial scan compared with follow-up scans.
More than half of the MRI examinations were ordered without a documented clinical indication. The researchers suggest that both patient expectations and physicians’ desire for additional reassurance may contribute to the extensive use of diagnostic imaging.
According to the authors, these findings raise questions about the necessity of routine follow-up MRI scans in patients with chronic low back pain when there is no suspicion of serious disease. They warn that unnecessary imaging may increase patient anxiety and lead to further investigations or treatments without proven benefit.
The study concludes that MRI findings in patients with chronic low back pain generally change very little over a two-year period and that repeat scans rarely provide new information that alters the course of treatment. The researchers hope that the results will contribute to a more targeted and appropriate use of MRI imaging within healthcare systems.
Tomé-Bermejo, F., Otero-Romero, D., Javier-Martínez, E. et al. How much does an MRI change over a period of up to 2 years in patients with chronic low back pain? Is a repeated MRI really necessary in the follow-up of patients with chronic low back pain?. European Spine Journal 2024.
Vil du vide mere?