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No Benefit from Early Imaging for Low Back Pain in Seniors

Early spine imaging for low back pain in seniors is not associated with better clinical outcomes, according to a JAMA study.

Researchers prospectively enrolled patients aged 65 and older presenting to primary or urgent care with low back pain. Roughly 1200 patients who underwent radiography within 6 weeks of presentation and 350 who underwent early advanced imaging were matched to controls who did not undergo early imaging.

The primary outcome — disability score at 12 months did not differ significantly between the early-imaging versus control groups. However, costs were about 30% higher and resource use was 40%–50% higher in the imaging groups.

NEJM Journal Watch General Medicine deputy editor Thomas Schwenk comments: "Although this was not a randomized controlled trial, results of this prospective cohort study suggest that the guidelines in which early imaging is discouraged in younger patients might apply equally well to older patients."