Appropriate use of lumbar imaging for evaluation of low back pain.
Use of lumbar spine imaging, particularly advanced imaging, continues to grow rapidly in the United States. Many lumbar spine imaging tests are obtained in patients who have no clinical symptoms or risk factors suggesting a serious underlying condition, yet evidence shows that this routine imaging is not associated with benefits, exposes patients to unnecessary harms, and increases costs. This article reviews current trends and practice patterns in lumbar spine imaging, direct and downstream costs, benefits and harms, current recommendations, and potential strategies for reducing imaging overuse.
Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA. chour@ohsu.edu
Roger
R
Chou
Richard A
RA
Deyo
Jeffrey G
JG
Jarvik
D006801:Humans; D017116:Low Back Pain / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D013122:Spinal Diseases / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States; D019564:Unnecessary Procedures