Introduction
The majority of IVD structural degenerations leading to neural compromise are progressive conditions which go unrecognized in their early stages. The approach of rest, medication, and reassurance is not always adequate in the management of spinal bio-mechanical dysfunctions.
Clear differentiation must be made between uncomplicated sprain / strains of the lower back, from discogenic IVD structural pathology, particularly in recurrent cases.
It seems that even in some advanced health care systems, under diagnosis, and certainly under treatment, have become routine.
Even so, the rising health care costs are cited as the justification. It seems the long term cost of progressive bio-mechanical disorders which may lead to surgical intervention or even disability, is significantly higher.
Therefore, the cost of an advanced imaging study such as an MRI study is well justified in early stage of selective cases, as it can provide valuable information regarding the bio-mechanical disorder, allowing for conservative treatment protocols such as the specific decompression procedures in the appropriate time frame.
This, of course, is more cost effective for both the patient as well as the health care system.
This particular patient, who had presented with exacerbated moderate – severe S1 radiculopathy, was also initially under diagnosed, and received treatment procedures which were unlikely to achieve positive results.
Therefore, a considerable amount of time was lost, which not only imposed unnecessary cost and suffering on the patient, but it also further complicated the treatment protocol.
