Paraspinal Mapping Superior to Imaging for Diagnosing Stenosis

A recent JAMA commentary by AANEM member Dr. Andy Haig, notes that while most surgeons use imaging to diagnose stenosis and make surgical recommendations, recent studies have shed doubt on the ability of imaging to confirm a diagnosis of stenosis. In contrast, new data has shown that paraspinal mapping can reliably identify patients with clinical stenosis. Haig says there are three key steps that need to be taken:“Find and treat what is not stenosis, define and treat the effects of stenosis, and treat presumed stenosis without a definitive diagnosis. Failing all of these steps, a positive diagnosis is an important consideration before surgery,” said Haig.

“I hope this commentary can begin a shift in the way some of these topics are considered and researched. Patients don’t present with stenosis; they present with back pain. As physicians, our guidelines should reflect that we diagnose and treat patients who have symptoms that help us make a diagnosis and treatment plan,” Haig concluded.

The commentary written was published in the January 6, 2010, issue of JAMA. The article was co-author by Christy Tomkins, PhD.