II. Precautions
- Imaging of the spine has an increasing False Positive Rate in older patients
- Correlate findings with Low Back Pain History and Low Back Pain Exam
- Cheung (2009) Spine 34(9): 934-40 [PubMed]
III. Imaging
- Indications
- Not recommended for routine Low Back Pain in the first 6 weeks
- Obtain for Low Back Pain Red Flag symptoms
- Obtain when surgery is being considered
- Procedures
- Lumbosacral Spine XRay
- Lumbar Spine MRI (Most accurate)
- Lumbar Spine CT Myelogram (Less accurate than MRI)
- Spine Bone Scan
IV. Diagnostics: Electrophysiologic Tests
- Indications
- Suspected nerve root dysfunction
- Persistent leg symptoms beyond 6 weeks
- Not recommended if radiculopathy is obvious from exam
- Testing
- Needle Electromyelogram (EMG)
- H-Reflex Tests