MRI Capacity Leads to Unnecessary Back Surgery

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