Vibration-based imaging could reduce excessive lower lumbar MRI

A new method of imaging the lower back using a noninvasive vibration technology called structural health monitoring (SHM) can distinguish functional changes in the spine and could help curb overuse of lumbar MRI, according to results of a study published online in Nature: Scientific Reports.

Back pain prevalence has risen as high as 83 percent in the United States in recent years, and is estimated to be responsible for as much as $625 billion dollars in total costs—counting both healthcare spending and indirect costs such as lost time at work—annually.

Much of that healthcare spending is the result of imaging overutilization, particularly lower lumbar MRI examinations, which have somewhat limited effectiveness in pinpointing issues associated with spinal function, according to Gregory Kawchuk, MD, of the University of Alberta in Edmonton, and colleagues.

“While the ideal circumstance would be to acquire both self-reported and direct measures of spinal function, direct measures are currently problematic,” they wrote. “Specifically, static visualization techniques such as [MRI] may not provide functional information, while other assessment techniques can be difficult to interpret or are difficult to employ due to cost, access and invasiveness.”

Kawchuk and his team collaborated with researchers from the University of Southern Denmark to conduct a study on the spines of identical twins. They performed both traditional lumbar MRI exams and noninvasive SHM evaluations on 10 pairs of identical twins—five that had normal back pain histories, and five in which one twin had sustained significant spinal trauma.

Their results showed that the new SHM technique recognized distinctions in spinal function much more effectively than MRI using vibration response patterns.

“In general, twins with similar spines had vibration responses that were statistically similar,” the researchers concluded. “Alternatively, twins with structurally dissimilar spines had vibration responses that were significantly different from each other.”

Kawchuk and his colleagues believe their results open the possibility for more research into the noninvasive SHM technology.

“Our data suggests that further investigation into the application of SHM in large human populations is justified,” they added, “in that SHM could provide a diagnostic alternative to existing procedures that are difficult to access, invasive or costly.”