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AuthorShraim, Bara A
AuthorShraim, Muath A
AuthorIbrahim, Ayman R
AuthorElgamal, Mohamed E
AuthorAl-Omari, Basem
AuthorShraim, Mujahed
Available date2021-12-12T06:34:52Z
Publication Date2021-11-24
Publication NameBMC Musculoskeletal Disorders
Identifierhttp://dx.doi.org/10.1186/s12891-021-04863-9
CitationShraim, B.A., Shraim, M.A., Ibrahim, A.R. et al. The association between early MRI and length of disability in acute lower back pain: a systematic review and narrative synthesis. BMC Musculoskelet Disord 22, 983 (2021). https://doi.org/10.1186/s12891-021-04863-9
URIhttp://hdl.handle.net/10576/25461
AbstractClinical guideline recommendations are against early magnetic resonance imaging (eMRI) within the first 4 to 6 weeks of conservative management of acute low back pain (LBP) without "clinical suspicion" of serious underlying conditions (red flags). There is some limited evidence that a significant proportion of patients with LBP receive eMRI non- indicated by clinical guidelines, which could be associated with increased length of disability (LOD). The aim of this systematic review was to investigate whether eMRI for acute LBP without red flags is associated with increased LOD. The LOD was defined as the number of disability days (absence from work). Medline, EMBASE, and CINAHL bibliographic databases were searched from inception until June 5, 2021. Two reviewers independently assessed the methodological quality of included studies using the Newcastle-Ottawa scale and extracted data for the review. The search identified 324 records, in which seven studies met the inclusion criteria. Three of the included studies used the same study population. Owing to between-study heterogeneity, a narrative synthesis of results was used. All included studies were of good methodological quality and consistently reported that patients with acute LBP without red flags who received eMRI had increased LOD compared to those who did not receive eMRI. Three retrospective cohort studies reported that the eMRI groups had a higher mean LOD than the no eMRI groups ranging from 9.4 days (95% CI 8.5, 10.2) to 13.7 days (95% CI 13.0, 14.5) at the end of 1-year follow-up period. The remaining studies reported that the eMRI groups had a higher hazard ratio of work disability ranging between 1.75 (95% CI 1.23, 2.50) and 3.57 (95% CI 2.33, 5.56) as compared to the no eMRI groups. eMRI is associated with increased LOD in patients with acute LBP without red flags. Identifying reasons for performing non-indicated eMRI and addressing them with quality improvement interventions may improve adherence to clinical guidelines and improve disability outcomes among patients with LBP.
Languageen
PublisherBMC
SubjectLow back pain
Magnetic resonance imaging
Return to work
Sick leave
Systematic review
Work disability
TitleThe association between early MRI and length of disability in acute lower back pain: a systematic review and narrative synthesis.
TypeArticle
Issue Number1
Volume Number22
ESSN1471-2474
dc.accessType Open Access


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