MRI Lumbar Spine With IV Contrast MRI lumbar spine with IV contrast is not typically performed independently as an initial study, as its interpretation is most informative when correlated with standard noncontrast sequences included in MRI lumbar spine with and without IV contrast [33]. Low Back Pain MRI Lumbar Spine Without and With IV Contrast Although MRI lumbar spine without IV contrast is the preferred initial study, MRI lumbar spine without and with IV contrast may be helpful to delineate etiology of CES when clinical suspicion of underlying malignancy, infection, or inflammation (see Variant 7). MRI Lumbar Spine Without IV Contrast MRI lumbar spine without IV contrast is most useful in the evaluation of suspected CES, multifocal deficit, or progressive neurologic deficit because of its ability to accurately depict soft-tissue pathology, assess vertebral marrow, and assess the spinal canal patency. A prospective cohort study by Bell et al [41] recommends urgent MRI assessment in all patients who present with new-onset urinary symptoms in the context of LBP or sciatica. Recently, a single 3-D heavily T2-weighted fat-saturated sequence protocol has been shown to be a rapid, highly sensitive tool for evaluating CES in the emergency department that can be utilized for improved efficiency and emergency department throughput [42]. Radiography Lumbar Spine There is no relevant literature to support the use of radiography in the initial imaging of suspected CES. Variant 5: Low back pain with history of prior lumbar surgery and with or without radiculopathy. New or progressing symptoms or clinical findings. Initial imaging. There are many causes of back pain following surgery. Some of the more frequent etiologies diagnosed with imaging include free disc or bone fragments, postoperative scarring, failure of bone graft for fusion, and recurrent disc protrusion.
Low Back Pain PCAs. MRI Lumbar Spine With IV Contrast MRI lumbar spine with IV contrast is not typically performed independently as an initial study, as its interpretation is most informative when correlated with standard noncontrast sequences included in MRI lumbar spine with and without IV contrast [33]. Low Back Pain MRI Lumbar Spine Without and With IV Contrast Although MRI lumbar spine without IV contrast is the preferred initial study, MRI lumbar spine without and with IV contrast may be helpful to delineate etiology of CES when clinical suspicion of underlying malignancy, infection, or inflammation (see Variant 7). MRI Lumbar Spine Without IV Contrast MRI lumbar spine without IV contrast is most useful in the evaluation of suspected CES, multifocal deficit, or progressive neurologic deficit because of its ability to accurately depict soft-tissue pathology, assess vertebral marrow, and assess the spinal canal patency. A prospective cohort study by Bell et al [41] recommends urgent MRI assessment in all patients who present with new-onset urinary symptoms in the context of LBP or sciatica. Recently, a single 3-D heavily T2-weighted fat-saturated sequence protocol has been shown to be a rapid, highly sensitive tool for evaluating CES in the emergency department that can be utilized for improved efficiency and emergency department throughput [42]. Radiography Lumbar Spine There is no relevant literature to support the use of radiography in the initial imaging of suspected CES. Variant 5: Low back pain with history of prior lumbar surgery and with or without radiculopathy. New or progressing symptoms or clinical findings. Initial imaging. There are many causes of back pain following surgery. Some of the more frequent etiologies diagnosed with imaging include free disc or bone fragments, postoperative scarring, failure of bone graft for fusion, and recurrent disc protrusion.