BACK PAIN ADMISSIONS: ROLE OF MRI SCAN

Background Back pain is a common orthopaedic problem which results in hospital admissions in severe cases. The aim of our study was to identify the reasons for back pain admissions and role of further investigations in the treatment of severe back pain. Methods We collected data prospectively for all admissions between January and March 2011. Demographic details were recorded along with the reasons for admissions, time of admission, further investigations and treatment offered. Results Total admissions were 850 and 58 (6.8%) had severe back pain.13 patients (22%) had fractures (Group-A); 16 patients (27%) did not require MRI scan (Group-B); 27 patients (50%) needed MRI scan of the lumbosacral spine (Group-C). The mean age of Group-A was 67 years (15–93). 3 were male and 10 females. 10 patients had lumbar and 3 had thoracic spine fractures. The mean age of Group-B was 59 years (32–87). 8 were male and 8 females. The mean age of Group-C was 47 years (23–79). 9 were male and 18 females. The mean hospital stay for Group-C was 5days (0–29). 16 patients (59%) were referred by GP, 5(18%) by emergency department and 3(11%) by physiotherapist. 9(43%) were admitted for pain control, 8(38%) with suspected Cauda Equina syndrome and 2(9%) for further investigations. 20 patients (83%) were admitted during the day, 3(12%) in the evening and 1(4%) during the night. No patient had Cauda equina syndrome on clinical and radiological examination. 12 patients(44%) had nerve root compression on the MRI scan and 7(58%) were offered surgery. Conclusions Patients were older in group-A with a mean age of 67 years. 27% did not require MRI scan. 67% females admitted with back pain required an MRI scan. No patient had Cauda Equina Syndrome. 55% patients had no nerve root compression. MRI scan was performed to reassure the patients and clinicians with negative results in the presence of severe back pain and unclear neurological signs. Conflicts of interest None Sources of funding None