TY - JOUR T1 - Relationship between spinal magnetic resonance imaging findings and candidacy for spinal surgery JF - Canadian Family Physician JO - Can Fam Physician SP - e323 LP - e330 VL - 56 IS - 9 AU - Frederick Cheng AU - John You AU - Y. Raja Rampersaud Y1 - 2010/09/01 UR - http://www.cfp.ca/content/56/9/e323.abstract N2 - OBJECTIVE To compare the prevalence of spinal abnormalities found on magnetic resonance imaging (MRI) in symptomatic surgical candidates and non-surgical patients. DESIGN Retrospective cohort study. SETTING A single academic spine surgery practice in Toronto, Ont. PARTICIPANTS A total of 1586 symptomatic patients referred during a 32-month period; based on chart review, patients were classified as surgical candidates (n = 722), non-surgical patients (n = 690), or indeterminate regarding surgical candidacy (n = 174). MAIN OUTCOME MEASURES Prevalence rates of different spinal abnormalities between the 2 cohorts, including type, severity, and number of levels of abnormalities detected on lumbar MRI. RESULTS The total number of abnormalities did not differ between the 2 groups (P = .26). The non-surgical group exhibited more degenerative disk disease (P < .01), while surgical candidates had a higher prevalence of spinal stenosis and spondylolisthesis (P < .01). In multivariate analysis, age (adjusted odds ratio [AOR] per 10-year increase 3.33, 95% confidence interval [CI] 3.32 to 3.33), disk herniation (AOR 1.49, 95% CI 1.16 to 1.89), spinal stenosis (AOR 1.61, 95% CI 1.26 to 2.05), and spondylolisthesis (AOR 2.83, 95% CI 2.08 to 3.88) were independent predictors of surgical candidacy. CONCLUSION These results might enable physicians without specialty training in spinal disorders to more effectively use MRI reports when deciding on referral to surgical or non-surgical specialists. In jurisdictions with long wait times for elective spinal surgery consultation, a more directed referral is one of many steps necessary to improve patient access and management. ER -