Relationship of early magnetic resonance imaging for work-related acute low back pain with disability and medical utilization outcomes.
OBJECTIVE
To examine early magnetic resonance imaging (MRI) utilization for workers compensation cases with acute, disabling low back pain and further, to examine low or high propensity to undergo early MRI with disability duration, medical costs, and surgery.


METHODS
Two-year follow-up of 3264 cases. Cox regression and generalized linear models were used to examine the association between both early MRI (first 30 days postonset) and propensity of belonging to the early MRI group (estimated by demographic and severity indicators) with outcomes.


RESULTS
A total of 21.7% cases had early MRI. After controlling for covariates, cases that had early MRI and simultaneously had a low propensity to undergo early MRI were more likely to have worse outcomes.


CONCLUSIONS
The majority of cases had no early MRI indications. Results suggest that iatrogenic effects of early MRI are worse disability and increased medical costs and surgery, unrelated to severity.
Webster
Barbara S
BS
Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA. Barbara.webster@libertymutual.com
Cifuentes
Manuel
M
D000208:Acute Disease; D000328:Adult; D019567:Back Injuries / Q000175:diagnosis* / Q000191:economics / Q000601:surgery; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007049:Iatrogenic Disease / Q000191:economics / Q000453:epidemiology; D016015:Logistic Models; D017116:Low Back Pain / Q000175:diagnosis* / Q000191:economics / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data; D011859:Radiography; D014942:Workers' Compensation / Q000706:statistics & numerical data*