Lumbar Disc High-intensity Zone

Schellhas, Kurt P.; Pollei, Steven R.; Gundry, Cooper R.; Heithoff, Kenneth B.

doi:10.1097/00007632-199601010-00018

Cited by 274 publications

(40 citation statements)

References 20 publications

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“…Similar clinical studies followed [5–7]. Chen et al [6] reported a correlation between the HIZ and positive concordant pain on discography, and Peng et al [8] and Dongfeng et al [9] found inflammation and neovascularization on histological analysis of disc material in the HIZ.…”

Section: Introductionmentioning

confidence: 57%

Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

Sugiura

Tonogai

Matsuura

et al. 2014

Case Reports in Orthopedics

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A 32-year-old man underwent radiofrequency thermal annuloplasty (TA) with percutaneous endoscopic discectomy (PED) under local anesthesia for chronic low back pain. His diagnosis was discogenic pain with a high signal intensity zone (HIZ) in the posterior corner of the L4-5 disc. Flexion pain was sporadic, and steroid injection was given twice for severe pain. After the third episode of strong pain, PED and TA were conducted. The discoscope was inserted into the posterior annulus and revealed a migrated white nucleus pulposus which was stained blue. Then, after moving the discoscope to the site of the HIZ, a migrated slightly red nucleus pulposus was found, suggesting inflammation and/or new vessels penetrating the mass. After removing the fragment, the HIZ site was ablated by TA. To our knowledge, this is the first report of the discoscopic findings of HIZ of the lumbar intervertebral disc.

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Section: Introductionmentioning

confidence: 57%

Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

Sugiura

Tonogai

Matsuura

et al. 2014

Case Reports in Orthopedics

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“…The findings of disc desiccation and the presence of a high-intensity zone have been shown to have a high correlation with an annular tear in most patients (25,26) (Fig. 4).…”

Section: Indications Idetmentioning

confidence: 87%

Treatment of Discogenic Back Pain

Silber¹,

McGraw²,

Lippert³

2004

Interventional Radiology of the Spine

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“…Carragee et al [31] highlighted the issue of iatrogenic degenerative changes from testing "healthy" control discs required for concordant testing, and drew attention to the significant influence of psychosocial overlay and secondary gains in false positive results. However, confusion still exists, with high sensitivity and specificity [32], high likelihood ratios [3334] and low false positive rates found in selected studies [35] which may be related to the technique using a pain-free control disc and volume related pressure [36]. …”

Section: Imagingmentioning

confidence: 99%

Operative Management of Lumbar Degenerative Disc Disease

2016

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Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term.

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Lumbar Disc High-intensity Zone

Abstract: In patients with symptomatic low back pain, the high-intensity zone is a reliable marker of painful outer anular disruption.

Cited by 274 publications

References 20 publications

Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

Treatment of Discogenic Back Pain

Operative Management of Lumbar Degenerative Disc Disease

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