There are few significant differences at 6 weeks or 1 year between patients who are referred for lumbar spine X-ray and those who are not. Patients who are referred appear to be in better mental health as measured within the SF-36 quality of life measure.
Implications for healthcare:
- Existing guidelines are sound. Early X-ray is not indicated, although it might still be considered when patient anxiety is a major feature.
- This reinforces the message that the benefit from early X-ray is negligible and that the X-ray dose is high.
- NHS costs at 6 weeks are higher among those referred for X-ray.
- This study suggests that there is little evidence that early X-ray referral leads to less morbidity reflected in time off work.