Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2019
Magnetic resonance spectroscopy (MRS) can identify painful lumbar discs and may facilitate improved clinical outcomes of lumbar surgeries for discogenic pain.
Observational study in 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, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06169488 (The Lumbar Interbody Fusion vs. Multidisciplinary Rehabilitation), which is not on this map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Lumbar Interbody Fusion vs. Multidisciplinary Rehabilitation (LIFEHAB) Trial
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Dynamic behavior of the nucleus pulposus within the intervertebral disc loading: a systematic review and meta-analysis exploring the concept of dynamic disc model.Frontiers in bioengineering and biotechnology · 2025Pooled it
- MR spectroscopy in the diagnosis of lumbar discogenic pain.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 · 2026Article
- Article
- Blood immune profiles in chronic low back pain patients with type 1 Modic changes are associated with intradiscal propionic acid levels.Research square · 2026Article
- Diagnostic Features of Discogenic Low Back Pain: A Narrative Review and Suggested Areas for Future Research and Clinical Practice.JOR spine · 2026Review
- Lactate metabolism reprogramming through orthogonal tandem catalysis to reverse intervertebral disc degeneration.Nature communications · 2026Article
- Article
- Article
- What a pain in the back: etiology, diagnosis and future treatment directions for discogenic low back pain.Bone research · 2025Review
- The design and rationale of the Biomarkers for Evaluating Spine Treatments trial: a sequential multiple assignment randomized trial.Pain medicine (Malden, Mass.) · 2025Article
- Bioactive Therapies for Degenerative Disc Disease: Microenvironmental Foundations of Disease.World neurosurgery · 2025Review
- Article
- Biologic Therapies for Discogenic Pain.Current pain and headache reports · 2025Review
- The Comparison of Cost-Effectiveness Between Magnetic Resonance Spectroscopy and Provocative Discography in the Identification of Chronic Low Back Pain Surgery Candidates.ClinicoEconomics and outcomes research : CEOR · 2025Article
- The advancement and utility of multimodal imaging in the diagnosis of degenerative disc disease.Frontiers in radiology · 2025Review
- Review
- Article
- Palmitic acid induces lipid droplet accumulation and senescence in nucleus pulposus cells via ER-stress pathway.Communications biology · 2024Article
- Establishing a Gold Standard for Noninvasive Identification of Painful Lumbar Discs: Prospective Comparison of Magnetic Resonance Spectroscopy vs Low-Pressure Provocation Discography.International journal of spine surgery · 2024Article
- Intervertebral disc human nucleus pulposus cells associated with back pain trigger neurite outgrowth in vitro and pain behaviors in rats.Science translational medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe goal of this study was to refine clinical MRS to optimize performance and then determine whether MRS-derived biomarkers reliably identify painful discs, quantify degeneration severity, and forecast surgical outcomes for chronic low back pain (CLBP) patients.
methodsWe performed an observational diagnostic development and accuracy study. Six hundred and twenty-three (623) discs in 139 patients were scanned using MRS, with 275 discs also receiving provocative discography (PD). MRS data were used to quantify spectral features related to disc structure (collagen and proteoglycan) and acidity (lactate, alanine, propionate). Ratios of acidity to structure were used to calculate pain potential. MRS-SCOREs were compared to PD and Pfirrmann grade. Clinical utility was judged by evaluating surgical success for 75 of the subjects who underwent lumbar surgery.
resultsTwo hundred and six (206) discs had both a successful MRS and independent pain diagnosis. When comparing to PD, MRS had a total accuracy of 85%, sensitivity of 82%, and specificity of 88%. These increased to 93%, 91%, and 93% respectively, in non-herniated discs. The MRS structure measures differed significantly between Pfirrmann grades, except grade I versus grade II. When all MRS positive discs were treated, surgical success was 97% versus 57% when the treated level was MRS negative, or 54% when the non-treated adjacent level was MRS positive.
conclusionMRS correlates with PD and may support improved surgical outcomes for CLBP patients. Noninvasive MRS is a potentially valuable approach to clarifying pain mechanisms and designing CLBP therapies that are customized to the patient. These slides can be retrieved under Electronic Supplementary Material.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.