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Routine X-Rays After Lumbar Fusion May Not Be Useful

Last Updated: July 10, 2009.

Routine X-rays appear to have limited usefulness in the year after lumbar spinal fusion, according to research published in the July 1 issue of Spine.

FRIDAY, July 10 (HealthDay News) -- Routine X-rays appear to have limited usefulness in the year after lumbar spinal fusion, according to research published in the July 1 issue of Spine.

Neil C. Romero, M.D., of the Medical University of South Carolina in Charleston, and colleagues analyzed data from 202 patients who underwent posterior instrumented lumbar spinal fusions. History and physical examinations from the first postoperative year were graded as normal (H/E NL) or abnormal (H/E NOT), as were X-rays.

The researchers discovered that, if the H/E was normal, and the X-ray was normal or not taken, no action was taken in these cases. If the H/E was normal and the X-rays were abnormal, further action was only taken in one case. When the H/E was abnormal and X-rays were normal, further action was taken 72 percent of the time, and when the H/E and X-rays were not normal, action was taken 89 percent of the time.

"We are not advocating that radiographs have no role in evaluating the symptomatic patient after lumbar spinal fusion. In fact, radiographs offer immediate information to the clinician. This information can be very valuable for reassuring patients and can help determine what additional testing is needed," the authors write. "We recommend minimizing the use of radiographs to evaluate H/E NL patients. In H/E NOT patients, radiographs should be used as an initial diagnostic study with the understanding that additional studies likely will ultimately guide treatment decisions."

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