BY JAMES M. BRICE

A study that found that neoplasms cause 3% of lower back pain cases may not be earthshaking, but in the context of managed-care trends the effects could be profound.

The study, conducted by Sattam Lingawi, an MRI fellow at Long Beach Memorial Hospital in Long Beach, CA, exemplifies a new generation of pre-emptive radiological science, where research anticipates the direction of managed-care policy, according to neuroradiologist William Bradley. In this case, the finding that neoplasms cause 3% of lower back pain cases may be noteworthy to managed-care administrators whose authority includes clamping down on extraneous MR exams. The results were presented at the RSNA meeting Sunday.

The trend for several years has been to restrict imaging for lower back pain cases, so it is not a big step to a complete ban on imaging for lower back, Bradley said. Prescribing six weeks of bed rest, the current preferred way of dealing with lower back pain, probably does no harm in the three of 100 cases that are caused by cancer, according to Bradley. This study shows, however, that a blanket prohibition against imaging by a payor could do great harm, he said.