Observer variability based on the strength of MR scanners in the assessment of lumbar degenerative disc disease

Cihangiroğlu, Mutlu; Yıldırım, Hanifi; Bozgeyik, Zülkif; Utku, S.; Özdemir, Hüseyin; Topsakal, Cahide; Yılmaz, Saim

doi:10.1016/j.ejrad.2003.08.004

Cited by 29 publications

(25 citation statements)

References 13 publications

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“…However, Boos et al pointed out that explanation of LBP and sciatica by MRI is questionable even in disk herniations despite its high diagnostic rate, since pathoanatomical alterations may not be directly related with the source of pain (4, 5). Furthermore, MRI or CT is not helpful to determine pain source in patients with somatic referred pain arising from the LZJ and SIJ (12, 25, 26). Considering the paucity of diagnostic maneuvers for somatic referred pain, PDPT is regarded to be uniquely useful in this situation.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Pain Distribution Pattern Assessment in Decision-Making for the Patients with Lumbar Zygapophyseal and Sacroiliac Joint Arthropathy

et al. 2007

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There are currently no initial guides for the diagnosis of somatic referred pain of lumbar zygapophyseal joint (LZJ) or sacroiliac joint (SIJ). We developed a classification system of LZJ and SIJ pain, the "pain distribution pattern template (PDPT)" depending on the pain distribution patterns from a pool of 200 patients whose spinal pain source was confirmed. We prospectively applied the PDPT to determine its contribution to clinical decision-making for 419 patients whose pain was presumed to arise from the LZJs (259 patients) or SIJs (160 patients). Forty-nine percent (128/259) of LZJ and 46% (74/160) of SIJ arthopathies diagnosed by PDPT were confirmed by nerve blocks. Diagnostic reliabilities were significantly higher in Type A and C patterns in LZJ and Type C in SIJ arthropathies, 64%, 80%, and 68.4%, respectively. For both LZJ and SIJ arthropathies, favorable outcome after radiofrequency (RF) neurotomies was similar to the rate of positive responses to diagnostic blocks in Type A to Type D, whereas the outcome was unpredictable in those with undetermined type (Type E). Considering the paucity of currently available diagnostic methods for LZJ and SIJ arthropathies, PDPT is useful in clinical decision-making as well as in predicting the treatment outcome.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Pain Distribution Pattern Assessment in Decision-Making for the Patients with Lumbar Zygapophyseal and Sacroiliac Joint Arthropathy

et al. 2007

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“…Second, evaluation of images obtained with low-field MRI scanners, as was used in this study, has been reported to have lower interobserver reproducibility when compared to that obtained with high-field scanners in one study of poor quality. 45 However, because our study was conducted in a research department, enough scan time was provided to obtain optimal images and acceptable reproducibility comparable to other studies using high-field systems. [46][47][48][49][50] The high quality of our images can be seen in Figure 2.…”

Section: Strengths and Weaknessesmentioning

confidence: 94%

Magnetic Resonance Imaging Findings as Predictors of Clinical Outcome in Patients With Sciatica Receiving Active Conservative Treatment

Jensen

Albert

Sorensen

et al. 2007

Journal of Manipulative and Physiological Therapeutics

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“…The conclusion was that ''in the diagnosis of root compression and spinal stenosis, the intra-and interobserver agreements were relative poor with both high and low-strength field MRIs.'' 50 Obviously, this lack of consistency plays a major role in surgical decision-making.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

The Diagnosis of the Origins of Spinal Pain: Implications for the Spinal Surgeon

Seres

2009

Neurosurgery Quarterly

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Surgery for common spinal disorders has changed dramatically in the last several decades. The failed surgical back syndrome patients populate a vast number of chronic pain clinics and rehabilitation facilities. New surgical procedures promise better outcomes. Yet documented improvement in imaging studies and the original promise of newer technologies have not consistently resulted in better clinical outcomes. More important than the technical success is the improved state of the patient. The search for the ''properly selected patient'' is a commonly used euphemism to explain away less ideal outcomes. Yet the phrase continues without clear specificity. The study is a review of some of the problems in planning the surgical care for the spinal patient. Spinal surgeons generally do not follow their patients after surgery long enough to fully comprehend the results and the impacts of their procedures, especially as viewed by the patient. We present an alternative approach that reduces the role of the spinal surgeon by encouraging more input from those who are likely to follow the patient who might not fare well. Experience in the treatment of surgical failures educates these practitioners to provide an evidence-based approach to surgical indications not as readily available to the spinal surgeon in many modern surgical practices.

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Observer variability based on the strength of MR scanners in the assessment of lumbar degenerative disc disease

Cited by 29 publications

References 13 publications

Usefulness of Pain Distribution Pattern Assessment in Decision-Making for the Patients with Lumbar Zygapophyseal and Sacroiliac Joint Arthropathy

Usefulness of Pain Distribution Pattern Assessment in Decision-Making for the Patients with Lumbar Zygapophyseal and Sacroiliac Joint Arthropathy

Magnetic Resonance Imaging Findings as Predictors of Clinical Outcome in Patients With Sciatica Receiving Active Conservative Treatment

The Diagnosis of the Origins of Spinal Pain: Implications for the Spinal Surgeon

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