Evidence map›Paper›PMID 34283305›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2021

Cerebrospinal fluid signal loss sign: assessment of a new radiological sign in lumbar spinal stenosis.

Mustafa Hızal, Faruk Özdemir, Oya Kalaycıoğlu, Cengiz Işık

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Article 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, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Use and misuse of the sedimentation sign in lumbar spine stenosis.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 · 2025
    Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Mustafa HızalDepartment of Radiology, Izzet Baysal Faculty of Medicine, Bolu Abant Izzet Baysal University, 14280, Bolu, Turkey.ORCID 0000-0002-4888-0962
Faruk ÖzdemirDepartment of Radiology, Izzet Baysal Faculty of Medicine, Bolu Abant Izzet Baysal University, 14280, Bolu, Turkey. ozdemir.frk@gmail.com.ORCID 0000-0002-7999-8058
Oya KalaycıoğluDepartment of Biostatistic and Informatics, Izzet Baysal Faculty of Medicine, Bolu Abant Izzet Baysal University, 14280, Bolu, Turkey.ORCID 0000-0003-2183-7080
Cengiz IşıkDepartment of Orthopedics and Traumatology, Izzet Baysal Faculty of Medicine, Bolu Abant Izzet Baysal University, 14280, Bolu, Turkey.ORCID 0000-0002-9750-9350

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSedimentation sign was reported to have high sensitivity and specificity for diagnosis of lumbar spinal stenosis (LSS). We aimed to determine cerebrospinal fluid signal loss (CSFSL) at the intervertebral disc levels in the sagittal plane using a numerical scoring system and to evaluate the diagnostic value of this method in differential diagnosis of LSS and non-specific low back pain (LBP) and compare it with SS. MATERIALS AND

methodsWe included consecutive patients between 50 and 80 years old, with lumbar spinal MRI examination in our institution. These patients were divided into two groups as LSS and LBP, according to symptoms and radiological findings. CSFSL sign was evaluated for both groups by two radiologists independently, using MR images. Sensitivity and specificity of both signs were calculated.

resultsA total of 406 patients (98 LSS and 308 non-specific LBP) were included. SS and CSFSL sign had a sensitivity of 90.8% and 82.7% and specificity of 75.4% and 84.1% in the whole cohort, respectively. When patients were grouped by dural sac cross-sectional areas (CSA), sensitivity and specificity of SS were 100% and 4.4%, 87.5% and 31.8%, and 41.7% and 76%, respectively, and sensitivity and specificity of CSFSL sign were 95.7% and 11.1%, 75% and 77.3%, and 16.7 and 92% for severe (CSA < 80 mm2), moderate (CSA: 80-100 mm2), mild (CSA: 100-120 mm2) radiologic stenosis, respectively. In moderate stenosis, accuracies of SS and CSFSL sign were 76.3% and 55.3%, respectively.

conclusionCSFSL sign might be used to distinguish LSS from LBP and unlike SS it is successful in moderate stenosis.

Indexed as

Spinal StenosisAgedAged, 80 and overHumansLumbar VertebraeLumbosacral RegionMagnetic Resonance ImagingMiddle AgedRadiographyCerebrospinal fluid signalDiagnostic testLumbar spinal stenosisMagnetic resonance imagingSedimentation test

Identifiers

PMID34283305

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Registered trials

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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.