ReviewInternational orthopaedics2019
The relevance of high-intensity zones in degenerative disc disease.
Review in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Platelet-Rich Plasma vs. Mesenchymal Stem Cells for Lumbar Disc Degeneration: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2026Pooled it
- Multi-parametric quantitative MRI for characterizing of lumbar intervertebral disc high-intensity zones in patients with chronic low back pain.Journal of orthopaedic surgery and research · 2026Article
- Diagnostic Features of Discogenic Low Back Pain: A Narrative Review and Suggested Areas for Future Research and Clinical Practice.JOR spine · 2026Review
- High-intensity zones in dogs with lumbosacral intervertebral disc degeneration: insights from MRI and histopathological findings.The veterinary quarterly · 2025Article
- Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options.Journal of orthopaedic surgery and research · 2025Review
- Role of Platelet-Rich Plasma (PRP) in the Management of Stage III and IV Degenerative Disc Disease.Cureus · 2025Review
- High intensity in interspinous ligaments: a diagnostic sign of lumbar instability and back pain for degenerative lumbar spondylolisthesis.BMC musculoskeletal disorders · 2024Article
- Male spondyloarthritis patients and those with longer disease duration have less severe disc degeneration: propensity score-matched comparison.Rheumatology advances in practice · 2024Article
- Characterization of annulus fibrosus lesions on magnetic resonance imaging in dogs affected by intervertebral disc disease, a descriptive case series.Frontiers in veterinary science · 2024Article
- MRI image features with an evident relation to low back pain: a narrative review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Review
- Review: Discogenic Back Pain: Update on Treatment.Orthopedic reviews · 2023Article
- Degenerative Disc Disease of the Spine: From Anatomy to Pathophysiology and Radiological Appearance, with Morphological and Functional Considerations.Journal of personalized medicine · 2022Review
- High-Intensity Zones on MRI of the Cervical Spine in Patients: Epidemiology and Association With Pain and Disability.Global spine journal · 2022Article
- Article
- Comparison of lumbar degenerative disc disease using conventional fast spin echoThe British journal of radiology · 2021Article
- Short-Term Outcome and Predictors of Therapeutic Effects of Intradiscal Condoliase Injection for Patients with Lumbar Disc Herniation.Spine surgery and related research · 2021Article
- The Clinical Diagnostic Value of Lumbar Intervertebral Disc Herniation Based on MRI Images.Journal of healthcare engineering · 2021Article
- The impact and distinction of 'lipid healthy but obese' and 'lipid abnormal but not obese' phenotypes on lumbar disc degeneration in Chinese.Journal of translational medicine · 2020Article
- Disc herniation and disc disease: the present and the future of management.International orthopaedics · 2019Article
- Lumbar lordosis as tool to assess the level of pain in patients with low back pain after lumbar disc herniation.Journal of orthopaedicsArticle
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to review the current understanding of high-intensity zones (HIZ) in the lumbar spine with particular attention to its imaging phenotype and clinical relevance.
methodsA review was conducted of studies related to HIZ. Particular attention was made to imaging phenotypes and classification, and its relationship with discogenic low back pain (LBP).
resultsThe most current classification system of HIZ is based on location (anterior and posterior), morphology (round, fissure, vertical, rim, or giant types), and its appearance on both T1- and T2-weighted magnetic resonance imaging (MRI). HIZ are commonly manifested with disc degeneration. Hence, both conditions share similar risk factors such as the effect of frequent and prolonged disc loading. The clinical significance of HIZ however is not conclusive. Provocative discography is not sensitive (~ 70%) for eliciting a concordant pain response. Population-based studies have conflicting results regarding the prevalence (14-63%) of HIZ and its correlation with LBP.
conclusionsHIZ are likely a risk factor for discogenic LBP. However, its etiology and pathophysiology are not well understood. Some clinical studies suggest a link between its occurrence and LBP. However, the results are not consistent as a result of studies which are underpowered and based on heterogeneous study populations, lacking control groups, and without standardized imaging phenotypes. HIZ may be an important pain biomarker that should be further studied. With more modern MRI technology and a detailed classification system, future large-scale population studies will improve our knowledge on its role in the disc degeneration cascade and development of LBP.
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