MRI Capacity Leads to Unnecessary Back Surgery

The accessibility and availability of Magnetic Resonance Imaging has been linked to an increase in low back surgery. Research published in the October issue of Health Affairs shows a statistical increase in the number of surgeries performed in correlation to the number of machines in a geographic area.
MRI scanners are a huge capital investment and a state of art machine costs more than $2 million dollars. A lower back scan is about $1500 per patient. The number of machines increased in a five year period from 7.6 machines per 1 million people in 2000 to 26.6 machines per million in 2005. That is more than tripling the number of MRI scanners in a geographical area in less than 5 years.
Researchers collected data from Medicare patient records who received care for nonspecific low back pain from 1998 through 2005. Established clinical guidelines recommend delaying MRI use for four weeks after the onset of pain because during this window most low back pain patients show spontaneous improvement. However, Healthy Habits For Students the study indicates that the introduction of an MRI scan increases the chances of surgery on the lower back. The researchers were able to determine that of the MRI scans that resulted due to the increased availability of machines two-thirds of the scans were performed within the first month of the onset of pain.
A Magnetic Resonance Image is a diagnostic procedure which uses magnetic fields to create detailed pictures inside the body and head. These pictures help to detect subtle changes in tissue matter. MRI’s are a medical marvel for ruling in or out specific causes of Lifestyle Change Plan back pain due to trauma or over use problems, such as a herniated disk. However, like any diagnostic tool it may also detect anomalies unrelated to back pain but will prompt doctors to perform surgery which may not benefit the patient and alleviate their pain.
In the report researchers suggest that each additional MRI scanner in an area results in 40 additional lower-back scans. If you extrapolate this to the whole Medicare population that means around 6,400 more scans in a MRI dense area than a non-MRI dense area. Researchers are concerned because of the close link between the scan and back surgeries.
From a healthcare reform angle this is very interesting research. Just because providers have access to high tech diagnostic tools they need to practice solid judgment when recommending MRIs. This study shows that the net result of increased use of MRI’s due to increased capacity raises the risks of unnecessary surgeries for patients and increased costs for everyone else.