tailieunhanh - Báo cáo y học: "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"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: 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. | Jensen et al. Chiropractic Osteopathy 2010 18 19 http content 18 1 19 CHIROPRACTIC OSTEOPATHY 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 files were identified. The two groups were similar in age sex and severity of LBP. However the median duration of treatment for the needs-based MRI group was 160 .