Purpose: To determine how much money could potentially be saved by re-evaluating a patient's prior recent abdominal CT for lumbar spine pathology instead of ordering a lumbar spine MRI.
Methods: Abdominal CT studies, from all consecutive patients who had an abdominal CT within 12 months prior to a lumbar spine MRI obtained between 11/1/15 and 5/30/16, were retrospectively reviewed in a blinded fashion for the presence of any significant lumbar spine abnormalities. CT studies that accurately reflected all normal and abnormal findings when compared to the standard of reference, the prospectively interpreted lumbar spine MR imaging reports, were used to indicate which lumbar spine MRI studies potentially could have been avoided and to calculate the potential cost savings.
Results: Of the 81 abdominal CT studies that met the inclusion criteria of this study, 62% (50/81) were TP, 28% (23/81) were TN, 5% (4/81) were FP, and 5% (4/81) were FN studies. 90% (73/81) of the lumbar spine MRI studies could potentially have been avoided during the 7 months of this study. The predicted savings by reviewing the abdominal CT for lumbar spine abnormalities prior to ordering a lumbar spine MRI are an estimated 1.2-3.4 billion dollars per year.
Conclusion: Recent abdominal CT studies should be reviewed for lumbar spine pathology prior to a patient undergoing lumbar spine MRI. Avoiding unnecessary lumbar spine MRI studies could potentially save the U.S. healthcare system an estimated 1.2-3.4 billion dollars per year.
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http://dx.doi.org/10.1007/s00261-017-1201-9 | DOI Listing |
J Ultrasound
January 2025
Musculoskeletal Ultrasound School, Italian Society for Ultrasound in Medicine and Biology, Bologna, Italy.
Objective: The aim of this work is to demonstrate how the chronicity of low back pain can modify the trophism of the paraspinal muscles, by performing an ultrasound and MRI evaluation of the paraspinal muscles in the lumbar spine and correlating it to the time of onset of low back pain.
Materials And Methods: An ultrasound evaluation was carried out in the lumbar area with a 5-17 MHz linear probe of the paraspinal muscles of the lumbar region, compared with the MRI of the lumbar spine, in patients presented to our attention for chronic low back pain (> 6 months), from January 2021 to January 2023. In each patient, two series of images were analyzed, in the coronal and sagittal planes.
Eur Spine J
January 2025
First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China.
JBJS Case Connect
October 2024
Department of Spine Surgery, Hospital for Special Surgery, New York, New York.
Case: A 73-year old man who underwent previous L2-S1 decompression presenting with new right radicular leg pain. Imaging suggests a large central disk herniation at L1-2 with possible intrathecal extension requiring surgical decompression. When positioned prone on a Jackson frame, neuromonitoring motor signals became diminished, and thus, the case was aborted.
View Article and Find Full Text PDFSpine (Phila Pa 1976)
January 2025
The Permanente Medical Group, Oakland, CA.
Study Design: A retrospective cohort study.
Objective: To determine if there is a difference in reoperations for adjacent segment disease (operative ASD) and nonunion (operative nonunion) in lumbar fusions that stop at T10/T11/T12 versus L1.
Summary Of Background Data: Current lumbar spine surgery is based on the belief that ASD occurs if fusions are stopped at L1 although there is varying evidence to support this assumption.
Cureus
December 2024
Department of Orthopedic Surgery, Spine and Spinal Cord Center, Osaka International Medical and Science Center, Osaka, JPN.
Introduction: Lumbar canal stenosis (LCS) is a common degenerative lumbar spinal disease (DLSD) widely treated by decompression surgery, also known as laminectomy. Few cases have been observed where DLSD has progressed postoperatively, thus requiring reoperation. However, data on such cases are limited.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!