Do Treatment Guidelines Influence Early MRI and Decompression Surgery for Low Back Pain?

By Dongchun Wang, Kathryn Mueller, Randall Lea, M.D.

August 28, 2019 Related Topics: Treatment Guidelines

Evidence-based treatment guidelines are widely considered to be useful in the delivery of consistent and cost-effective care, especially for several medical procedures used in treating low back pain (e.g., early magnetic resonance imaging [MRI], epidural steroid injections, discectomy/decompression surgery, lumbar fusion, and disc replacement).

Previous WCRI studies highlighted large interstate variations in utilization of these common procedures and substantial differences in the state policies regarding treatment guidelines and utilization management. As the second in a series of treatment guidelines studies, this study seeks to quantify the use of early MRI and lumbar decompression surgery for injured workers with low back pain in 27 states. It also attempts to interpret the interstate variation in patterns of care in the context of state policies regarding medical treatment guidelines and utilization management.

The study includes claims from 27 states, with injuries from October 1, 2015, through March 31, 2017. Detailed medical transactions for these claims cover the first year of treatment from the date of injury up through March 31, 2018. The 27 states are Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

Do Treatment Guidelines Influence Early MRI and Decompression Surgery for Low Back Pain? Dongchun Wang, Kathryn Mueller, and Randy Lea. August 2019. WC-19-45.



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