Outcome of acute hospital admission for non-specific low back pain: what is the role of MRI?

BACKGROUND: Low back pain is a common worldwide condition, affecting most people during their lifetime. Various imaging modalities are being used to assist clinicians in diagnosing and thus, aid in formulating a suitable management plan. Extensive research has been carried out in assessing this condition due to its high prevalence, with many guidelines published internationally.

AIM: To determine whether MRI imaging influences the management of patients admitted with acute, non-specific low back pain between 1 January 2013 and 31 December 2015.

METHOD: A total of 209 patients who met the inclusion criteria were included in the study. Suitable patients were initially identified from the ward admission book. Subsequently, relevant data regarding patient admission and management within the two-year period were obtained from the hospital patient management system, including radiology reports.

RESULTS: Out of the 209 patients included in this study, 131 patients (63%) had an MRI as part of the diagnostic process. Most patients were managed non-operatively with only 41 (20%) out of the 209 patients having undergone acute surgery while an inpatient. In this subgroup, 38 had an MRI done prior to surgery. Among the 168 patients who were treated non-operatively, including epidural steroid injection, 13 patients (8%) had elective surgery within one year from their initial presentation.

CONCLUSION: Use of MRI can aid in the early diagnosis and facilitate faster rehabilitation for patients. It can also potentially reduce patient stay in hospital and result in significant cost savings for the healthcare system. Imaging guidelines should be developed in the assessment of patients with low back pain in an acute hospital setting.