ArticleBMC musculoskeletal disorders2020
Clinical features as predictors of histologically confirmed inflammation in patients with lumbar disc herniation with associated radiculopathy.
Article in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 16 citations in OpenAlex.
- Distinguishing reactive scoliosis: clinical presentation, pathophysiology and a proposed clinical framework.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 · 2026Review
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- Surgical management of symptomatic retroperitoneal migratory disc herniation anterior to the sacral ala causing L5 radiculopathy using direct decompression and fusion: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
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- The predictive value of neutrophil-to-lymphocyte ratio in the efficacy of percutaneous lumbar disc radiofrequency ablation for lumbar disc herniation.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- An additional double inversion recovery sequence prompting a change in surgical approach: a case description.Quantitative imaging in medicine and surgery · 2024Article
- Patient and Staff Insights on Digital Care Pathways for Patients With Low Back Pain in the Emergency Department: A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Osteoid osteoma presenting with scoliosis: successful resection with endoscopic excision.BMJ case reports · 2024Article
- Asymmetric distribution of Modic changes in patients with lumbar disc herniation.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 · 2023Article
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- Spontaneous correction of scoliosis after curettage of spinal osteoid osteoma: How and when?Journal of orthopaedic surgery and research · 2022Article
- A comparative study of single and double incision for L4/5 and L5/S1 double-level percutaneous interlaminar lumbar discectomy.Frontiers in surgery · 2022Article
- The Thermosensitive Injectable Celecoxib-Loaded Chitosan Hydrogel for Repairing Postoperative Intervertebral Disc Defect.Frontiers in bioengineering and biotechnology · 2022Article
- Clinical and pathological considerations in lumbar herniated disc associated with inflammatory lesions.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologieArticle
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn understanding of the clinical features of inflammation in low back pain with or without leg symptoms may allow targeted evaluations of anti-inflammatory treatment in randomised-controlled-trials and clinical practice. PURPOSE: This study evaluated the diagnostic accuracy of clinical features to predict the presence/absence of histologically confirmed inflammation in herniated disc specimens removed at surgery in patients with lumbar disc herniation and associated radiculopathy (DHR). STUDY
designCohort Study.
methodsDisc material from patients with DHR undergoing lumbar discectomy was sampled and underwent histological/immunohistochemistry analyses. Control discs were sampled from patients undergoing surgical correction for scoliosis. Baseline assessment comprising sociodemographic factors, subjective examination, physical examination and psychosocial screening was conducted and a range of potential clinical predictors of inflammation developed based on the existing literature. Multi-variate analysis was undertaken to determine diagnostic accuracy.
resultsForty patients with DHR and three control patients were recruited. None of the control discs had evidence of inflammation compared to 28% of patients with DHR. Predictors of the presence of histologically confirmed inflammation included back pain < 5/10, symptoms worse the next day after injury, lumbar flexion range between 0 and 30° and a positive clinical inflammation score (at least 3 of: constant symptoms, morning pain/stiffness greater than 60-min, short walking not easing symptoms and significant night symptoms). The model achieved a sensitivity of 90.9%, a specificity of 92.9%, and a predictive accuracy of 92.3%.
conclusionIn a sample of patients with lumbar DHR a combination of clinical features predicted the presence or absence of histologically confirmed inflammation. CLINICAL RELEVANCE: These clinical features may enable targeted anti-inflammatory treatment in future RCTs and in clinical practice.
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