Many studies have concluded that in younger patients, an MRI should be delayed at least 6 to 8 weeks and probably not done unless patients have sciatica. Reasons for this decision include the fact that the MRI does not usually change management, as most acute disk herniations causing sciatica improve spontaneously, and findings may lead to unnecessary surgery.
Older adults were thought to be at higher risk of more serious causes such as cancer. A new study, however, has shown that the guidelines fit older adults as well. Early imaging led to increased costs of 30%. There was no benefit to patients.
Jack Florin, MD
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