Use of lumbar spine films. Statistical evaluation at a university teaching hospital

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Abstract
Use of lumbar spine films was evaluated in a retrospective review of 1095 lumbar radiological examinations in 871 patients. Patients'' histories and physical examination findings were correlated with 4 groups of radiological findings: radiologically normal; incidental findings unrelated to patients'' complaints; diagnostic films compatible with symptoms; and radiological findings of questionable significance. The high percentage of nondiagnostic and questionable results suggests overuse of lumbar spine films. Of all studies, 46% were normal or had incidental findings, and an additional 1.8% had radiological findings of questionable clinical significance. Follow-up examinations (375, 64.2%) demonstrated no radiological interval changes. Radiation exposure and medical cost of noncontributory studies may be substantially reduced by judicious consideration of the potential diagnostic yield of the examination and by careful selection of repeated or follow-up studies.

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