Lumbar spine MRI for low back pain: indications and yield

Low back pain is one of the most common causes of physician visits in the United States with an enormous socioeconomic burden. Because of this burden, numerous studies have focused on its diagnosis and management. New technologies have been quickly adopted with the hope that they will improve our understanding of the physiopathology of the disease and assist us in alleviating patients' pain and discomfort. Unfortunately, previous studies have not been able to show that higher utilization of advanced imaging technology is associated with improvements in patient outcome. This article highlights practices that are evidence-based versus those that are common, or heterogeneous, but not supported by existing evidence. We also highlight outstanding areas for further research.

Clinicians and researchers should be encouraged to follow standardized practices in accordance with evidence-based medicine guidelines. The use of such guidelines will decrease variation in care, allowing researchers to more easily design and conduct comparative effectiveness studies of diagnostic imaging.