Use of lumbar spine films. Statistical evaluation at a university teaching hospital
J. G. Scavone, R. F. Latshaw and G. V. Rohrer
Use of lumbar spine films was evaluated in a retrospective review of 1,095
lumbar radiological examinations in 871 patients. Patients' histories and
physical examination findings were correlated with four groups of
radiological findings: (1) radiologically normal, (2) incidental findings
unrelated to patients' complaints, (3) diagnostic films compatible with
symptoms, and (4) radiological findings of questionable clinical
significance. The high percentage of nondiagnostic and questionable results
suggests overuse of lumbar spine films. Forty-six percent of all studies in
this investigation were normal or had incidental findings, and an
additional 31.8% had radiological findings of questionable clinical
significance. Three hundred seventy-five follow-up examinations (64.2%)
demonstrated no radiological interval changes. Radiation exposure and
medical cost of noncontributory studies may be substantially reduced by
judicious consideration of the potential diagnostic yield of the
examination and by careful selection of repeated or follow-up studies.
