What do Bill, Arnold, and Ozzy Have in Common?

bill, arnold, and ozzy.jpg

What do Bill, Arnold, and Ozzy have in common?

A positive MRI or CT scan that shows spine degeneration.

How do I know this?

I haven't seen their medical imaging or assessed them.  But I know their age.  And spine "degeneration" is a normal process of aging that occurs in all individuals.  

It's like wrinkles, but on the inside.  Wrinkles don't hurt.  We don't need a facelift for our face to function.

The Proof

A recent systematic review (high level of evidence) supports the notion that "positive findings" on MRIs shouldn't be considered abnormal.

"The results from this systematic review strongly suggest that when degenerative spine findings are incidentally seen (ie, as part of imaging for an indication other than pain or an incidental disk herniation at a level other than where a patient’s pain localizes), these findings should be considered as normal age-related changes rather than pathologic processes.

With a prevalence of degenerative findings of >90% in asymptomatic individuals 60 years of age or older, our study supports the hypothesis that degenerative changes observed on CT and MR imaging are often seen with normal aging."

 key word is asymptomatic, none of these patients had any pain, yet they had positive findings ( image source )

key word is asymptomatic, none of these patients had any pain, yet they had positive findings (image source)

Summary

Structure does not dictate function. 

Over and over again, studies support this concept.  We are not our medical scans. 

Imaging is just a small part of the puzzle that may or may not be pertinent (depending on the individual).

Getting surgery based solely on medical imaging is a bad decision on the patient's part.  Suggesting surgery based solely on medical imaging is bad medicine on the surgeon's part.

If your medical provider is trying to convince you of aggressive medical interventions (drugs, shots, surgery) based on imaging then you should walk out the door and find better care.