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MRI cost low back pain

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https://www.readbyqxmd.com/read/30309987/is-establishing-a-specialist-back-pain-assessment-and-management-service-in-primary-care-a-safe-and-effective-model-twelve-month-results-from-the-back-pain-assessment-clinic-bac-prospective-cohort-pilot-study
#1
John H Y Moi, Uyen Phan, Adam de Gruchy, Danny Liew, Tanya I Yuen, John E Cunningham, Ian P Wicks
OBJECTIVES: To report on the design, implementation and evaluation of the safety and effectiveness of the Back pain Assessment Clinic (BAC) model. DESIGN: BAC is a new, community-based specialist service for assessing and managing neck and low back pain (LBP). The BAC pilot was supported by a Victorian Department of Health and Human Services grant and was evaluated using the Victorian Innovation Reform Impact Assessment Framework (VIRIAF). Data were obtained by auditing BAC activity (22 July 2014 to 30 June 2015) and conducting surveys and interviews of patients, stakeholders and referrers...
October 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/30159203/transforaminal-epidural-steroid-injection-can-result-in-further-neurological-injury-in-a-patient-with-severe-foraminal-stenosis-and-nerve-impingement
#2
Ramsis F Ghaly, Thomas Zouki, Aby Pynadath, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Chronic low back pain (LBP) is highly prevalent and costly in our society. The use of epidural steroid injections (ESIs) for the treatment of radicular LBP is very widespread and continues to rise. The most popular injection is the lumbar/sacral transforaminal epidural steroid injection (TFESI). Here, we present a serious neurological complication resulting from such a TFESI that was only reversed by timely neurosurgical intervention. Case Description: A 49-year-old male presented with a 5-year history of progressive neurogenic claudication and right lower extremity pain/radiculopathy...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/30090998/facet-joint-syndrome-from-diagnosis-to-interventional-management
#3
REVIEW
Romain Perolat, Adrian Kastler, Benjamin Nicot, Jean-Michel Pellat, Florence Tahon, Arnaud Attye, Olivier Heck, Kamel Boubagra, Sylvie Grand, Alexandre Krainik
Low back pain (LBP) is the most common pain syndrome, and is an enormous burden and cost generator for society. Lumbar facet joints (FJ) constitute a common source of pain, accounting for 15-45% of LBP. Facet joint degenerative osteoarthritis is the most frequent form of facet joint pain. History and physical examination may suggest but not confirm facet joint syndrome. Although imaging (radiographs, MRI, CT, SPECT) for back pain syndrome is very commonly performed, there are no effective correlations between clinical symptoms and degenerative spinal changes...
October 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29668650/impact-of-an-advanced-imaging-utilization-review-program-on-downstream-health-care-utilization-and-costs-for-low-back-pain
#4
Janessa M Graves, Deborah Fulton-Kehoe, Jeffrey G Jarvik, Gary M Franklin
BACKGROUND: Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. OBJECTIVES: To assess the impact of a state policy implemented in June 2010 that required prospective utilization review (UR) for early MRI among workers' compensation claimants with LBP. RESEARCH DESIGN: Interrupted time series...
June 2018: Medical Care
https://www.readbyqxmd.com/read/29246188/antibiotic-treatment-in-patients-with-chronic-low-back-pain-and-modic-changes-the-aim-study-study-protocol-for-a-randomised-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
Kjersti Storheim, Ansgar Espeland, Lars Grøvle, Jan Sture Skouen, Jörg Aßmus, Audny Anke, Anne Froholdt, Linda M Pedersen, Anne Julsrud Haugen, Terese Fors, Elina Schistad, Olav Lutro, Gunn Hege Marchand, Thomas Kadar, Nils Vetti, Sigrun Randen, Øystein Petter Nygaard, Jens Ivar Brox, Margreth Grotle, John-Anker Zwart
BACKGROUND: A previous randomised controlled trial (RCT) of patients with chronic low back pain (LBP) and vertebral bone marrow (Modic) changes (MCs) on magnetic resonance imaging (MRI), reported that a 3-month, high-dose course of antibiotics had a better effect than placebo at 12 months' follow-up. The present study examines the effects of antibiotic treatment in chronic LBP patients with MCs at the level of a lumbar disc herniation, similar to the previous study. It also aims to assess the cost-effectiveness of the treatment, refine the MRI assessment of MCs, and further evaluate the impact of the treatment and the pathogenesis of MCs by studying genetic variability and the gene and protein expression of inflammatory biomarkers...
December 15, 2017: Trials
https://www.readbyqxmd.com/read/29240738/outcome-of-acute-hospital-admission-for-non-specific-low-back-pain-what-is-the-role-of-mri
#6
Eric Ta Lim, Jean-Claude Theis
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...
December 15, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29230905/muscle-control-and-non-specific-chronic-low-back-pain
#7
REVIEW
Marc Russo, Kristiaan Deckers, Sam Eldabe, Kyle Kiesel, Chris Gilligan, John Vieceli, Peter Crosby
OBJECTIVES: Chronic low back pain (CLBP) is the most prevalent of the painful musculoskeletal conditions. CLBP is a heterogeneous condition with many causes and diagnoses, but there are few established therapies with strong evidence of effectiveness (or cost effectiveness). CLBP for which it is not possible to identify any specific cause is often referred to as non-specific chronic LBP (NSCLBP). One type of NSCLBP is continuing and recurrent primarily nociceptive CLBP due to vertebral joint overload subsequent to functional instability of the lumbar spine...
January 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29151051/subclinical-propionibacterium-acnes-infection-estimation-in-the-intervertebral-disc-spine-id-protocol-for-a-prospective-cohort
#8
Nelson Astur, Delio E Martins, Marcelo Wajchenberg, Mario Ferretti, Fernando G Menezes, Andre M Doi, Laercio A Rosemberg, Durval C B Santos, Alexandre S Iutaka, Luciano M R Rodrigues, Marines D V Martino, Jorge R Pagura, Eduardo N Kihara Filho, Mario Lenza
INTRODUCTION: Low back pain and vertebral endplate abnormalities are common conditions within the population. Subclinical infection caused by indolent pathogens can potentially lead to these findings, with differentiation between them notably challenging from a clinical perspective. Progressive infection of the intervertebral disc has been extensively associated with increasing low back pain, with Propionibacterium acnes specifically implicated with in relation to sciatica. The main purpose of this study is to identify if the presence of an infective pathogen within the intervertebral disc is primary or is a result of intraoperative contamination, and whether this correlates to low back pain...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28742099/variants-of-acan-are-associated-with-severity-of-lumbar-disc-herniation-in-patients-with-chronic-low-back-pain
#9
Romain Shanil Perera, Poruwalage Harsha Dissanayake, Upul Senarath, Lalith Sirimevan Wijayaratne, Aranjan Lional Karunanayake, Vajira Harshadeva Weerabaddana Dissanayake
INTRODUCTION: Disc herniation is a complex spinal disorder associated with disability and high healthcare cost. Lumbar disc herniation is strongly associated with disc degeneration. Candidate genes of the aggrecan metabolic pathway may associate with the severity of lumbar disc herniation. OBJECTIVES: This study evaluated the association of single nucleotide variants (SNVs) of the candidate genes of the aggrecan metabolic pathway with the severity of lumbar disc herniation in patients with chronic mechanical low back pain...
2017: PloS One
https://www.readbyqxmd.com/read/28401118/frequency-of-and-variation-in-low-value-care-in-primary-care-a-retrospective-cohort-study
#10
Ciara Pendrith, Meghan Bhatia, Noah M Ivers, Graham Mecredy, Karen Tu, Gillian A Hawker, Susan B Jaglal, Lynn Wilson, Kimberly Wintemute, Richard H Glazier, Wendy Levinson, R Sacha Bhatia
BACKGROUND: Low-value care, defined as care with a lack of benefit, can lead to higher health care costs, inconvenience to patients and, in some cases, harm to patients. The objectives of this study are to conduct exploratory analyses to understand how frequently selected low-value tests are ordered, to assess the degree of variation in ordering that exists across regions and practices, and to identify services that may warrant further investigation and targeted interventions. METHODS: We conducted a population-based retrospective cohort study using administrative health care databases from Ontario to identify rates of use of the following low-value services between fiscal years 2008/09 and 2012/13: computed tomography (CT) or magnetic resonance imaging (MRI) after a diagnosis of low back pain, Papanicolaou testing in women less than 21 years of age or older than 69 years of age and repeated dual-energy X-ray absorptiometry (DEXA) scanning within 2 years of an index scan...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28375914/low-back-pain
#11
REVIEW
Jinny O Tavee, Kerry H Levin
PURPOSE OF REVIEW: This article provides an overview of evaluating and treating low back pain in the outpatient setting. RECENT FINDINGS: As most cases of acute low back pain have a favorable prognosis, current guidelines on imaging studies recommend conservative treatment for 6 weeks prior to obtaining an MRI if no red flags are present. Of these red flags, a prior history of cancer is the strongest risk factor for a malignant etiology and requires urgent evaluation with MRI...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27867079/variability-in-diagnostic-error-rates-of-10-mri-centers-performing-lumbar-spine-mri-examinations-on-the-same-patient-within-a-3-week-period
#12
Richard Herzog, Daniel R Elgort, Adam E Flanders, Peter J Moley
BACKGROUND CONTEXT: In today's health-care climate, magnetic resonance imaging (MRI) is often perceived as a commodity-a service where there are no meaningful differences in quality and thus an area in which patients can be advised to select a provider based on price and convenience alone. If this prevailing view is correct, then a patient should expect to receive the same radiological diagnosis regardless of which imaging center he or she visits, or which radiologist reviews the examination...
April 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27669047/imaging-pediatric-spondylolysis-a-systematic-review
#13
REVIEW
Josef N Tofte, Tyler L CarlLee, Andrew J Holte, Sean E Sitton, Stuart L Weinstein
STUDY DESIGN: A systematic review. OBJECTIVE: The aim of this study was to provide an evidence-based recommendation for when and how to employ imaging studies when diagnosing back pain thought to be caused by spondylolysis in pediatric patients. SUMMARY OF BACKGROUND DATA: Spondylolysis is a common structural cause of back pain in pediatric patients. The radiologic methods and algorithms used to diagnose spondylolysis are inconsistent among practitioners...
May 15, 2017: Spine
https://www.readbyqxmd.com/read/26743429/feasibility-of-mr-elastography-of-the-intervertebral-disc
#14
Ephraim I Ben-Abraham, Jun Chen, Joel P Felmlee, Phil Rossman, Armando Manduca, Kai-Nan An, Richard L Ehman
Low back pain (LBP) is a costly and widely prevalent health disorder in the U.S. One of the most common causes of LBP is degenerative disc disease (DDD). There are many imaging techniques to characterize disc degeneration; however, there is no way to directly assess the material properties of the intervertebral disc (IVD) within the intact spine. Magnetic resonance elastography (MRE) is an MRI-based technique for non-invasively mapping the mechanical properties of tissues in vivo. The purpose of this study was to investigate the feasibility of using MRE to detect shear wave propagation in and determine the shear stiffness of an axial cross-section of an ex vivo baboon IVD, and compare with shear displacements from a finite element model of an IVD motion segment in response to harmonic shear vibration...
June 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/26703525/criterion-validity-of-ultrasound-imaging-assessment-of-multifidi-cross-sectional-area-in-older-adults-with-and-without-chronic-low-back-pain
#15
Jaclyn Megan Sions, Deydre S Teyhen, Gregory E Hicks
BACKGROUND AND PURPOSE: Ultrasound (US) imaging may be a cost-conscious alternative to magnetic resonance imaging (MRI), which is the criterion standard for muscle cross-sectional area (CSA) assessment. Within the trunk, when compared with MRI, US has been shown to be valid for assessing lumbar multifidi CSA in younger, asymptomatic individuals. To date, there are no studies validating US for multifidi CSA assessment in older adults or individuals with low back pain. Given age- and pain-related muscle changes, validation of US is needed in these populations...
April 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/26280717/should-a-lumbar-mri-for-back-pain-routinely-include-the-sacro-iliac-joint
#16
Francis Brooks, Vasu Shanbhag, Adel Ghandour, John Howes, Paul Davies, Kath Lyons, Sashin Ahuja
BACKGROUND: Back pain is a common problem and has been shown to affect approximately 85% of the adult population at any one time. The source of this pain can be difficult to identify and the sacroiliac joint (SIJ) has been proposed as a possible pain source. Its percentage contribution to lower back pain is controversial. Clinical provocative tests for SIJ pathology have been developed but these have high intra and inter-observer variability and the significant of positive findings is unclear...
December 2014: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/26247548/climbing-has-a-positive-impact-on-low-back-pain-a-prospective-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Martina Schinhan, Benedikt Neubauer, Karin Pieber, Michael Gruber, Franz Kainberger, Clara Castellucci, Boris Olischar, Andrea Maruna, Reinhard Windhager, Manuel Sabeti-Aschraf
OBJECTIVE: Comparison of climbing versus no treatment to treat chronic low back pain. DESIGN: Prospective randomized controlled trial. SETTING: Tertiary. PARTICIPANTS: A total of 30 patients with chronic low back pain were recruited and randomly assigned to 2 different groups: climbing and control. The inclusion criteria were defined as chronic low back pain, age between 18 and 45 years, body mass index lower than 25, and no climbing experience...
May 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/25883773/the-role-of-ultrasound-in-diagnosis-of-the-causes-of-low-back-pain-a-review-of-the-literature
#18
REVIEW
Pedram Heidari, Farzin Farahbakhsh, Mohsen Rostami, Pardis Noormohammadpour, Ramin Kordi
CONTEXT: Low back pain (LBP) is among the most prevalent musculoskeletal conditions in the developed countries. It is a common problem causing disability and imposing a huge economic burden to individuals and state organizations. Imaging plays an important role in diagnosis of the etiology of LBP. EVIDENCE ACQUISITION: The electronic databases included: PubMed (1950 to present), Ovid SP Medline (1950 to present) and ISI (1982 to present) and Google Scholar. In every search engine another search was performed using various permutations of the following keywords: ultrasonography, ultrasound imaging, low back pain, back muscles, paraspinal muscles, multifidus, transverse abdominis, muscle size, spinal canal, sacroiliac joint and spondylolisthesis...
March 2015: Asian Journal of Sports Medicine
https://www.readbyqxmd.com/read/25803219/diagnostic-accuracy-of-lumbosacral-spine-magnetic-resonance-image-reading-by-chiropractors-chiropractic-radiologists-and-medical-radiologists
#19
Annemarie de Zoete, Raymond Ostelo, Dirk L Knol, Paul R Algra, Jan T Wilmink, Maurits W van Tulder
STUDY DESIGN: A cross-sectional diagnostic accuracy study was conducted in 2 sessions. OBJECTIVE: It is important to know whether it is possible to accurately detect "specific findings" on lumbosacral magnetic resonance (MR) images and whether the results of different observers are comparable. SUMMARY OF BACKGROUND DATA: Health care providers frequently use magnetic resonance imaging in the diagnostic process of patients with low back pain...
June 1, 2015: Spine
https://www.readbyqxmd.com/read/25621106/mesenchymal-stem-cell-tracking-in-the-intervertebral-disc
#20
REVIEW
Charles Handley, Tony Goldschlager, David Oehme, Peter Ghosh, Graham Jenkin
Low back pain is a common clinical problem, which leads to significant social, economic and public health costs. Intervertebral disc (IVD) degeneration is accepted as a common cause of low back pain. Initially, this is characterized by a loss of proteoglycans from the nucleus pulposus resulting in loss of tissue hydration and hydrostatic pressure. Conservative management, including analgesia and physiotherapy often fails and surgical treatment, such as spinal fusion, is required. Stem cells offer an exciting possible regenerative approach to IVD disease...
January 26, 2015: World Journal of Stem Cells
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