Evidence map›Paper›PMID 36549846›Full record

ArticleAJNR. American journal of neuroradiology2023

Enhancing Annular Fissures and High-Intensity Zones: Pain, Internal Derangement, and Anesthetic Response at Provocation Lumbar Discography.

W S Bartynski, V Agarwal, H Trang, A I Bandos, W E Rothfus, J Tsay, W T Delfyett, B Nastasi

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in AJNR. American journal of neuroradiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 24% of its field
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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. 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

8 authors at 2 institutions in 3 countries.

W S BartynskiFrom the Department of Radiology (W.S.B., V.A., H.T., W.E.R., J.T., W.T.D., B.N.), Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pennsylvania walter.bartynski@gmail.com.ORCID 0000-0002-8276-0884
V AgarwalFrom the Department of Radiology (W.S.B., V.A., H.T., W.E.R., J.T., W.T.D., B.N.), Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pennsylvania.ORCID 0000-0002-7086-0239
H TrangFrom the Department of Radiology (W.S.B., V.A., H.T., W.E.R., J.T., W.T.D., B.N.), Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pennsylvania.ORCID 0000-0002-6307-4387
A I BandosDepartment of Biostatistics (A.I.B.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.ORCID 0000-0001-5629-1415
W E RothfusFrom the Department of Radiology (W.S.B., V.A., H.T., W.E.R., J.T., W.T.D., B.N.), Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pennsylvania.ORCID 0000-0001-9772-9604
J TsayFrom the Department of Radiology (W.S.B., V.A., H.T., W.E.R., J.T., W.T.D., B.N.), Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pennsylvania.ORCID 0000-0002-8406-177X
W T DelfyettFrom the Department of Radiology (W.S.B., V.A., H.T., W.E.R., J.T., W.T.D., B.N.), Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pennsylvania.ORCID 0000-0003-1721-4163
B NastasiFrom the Department of Radiology (W.S.B., V.A., H.T., W.E.R., J.T., W.T.D., B.N.), Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pennsylvania.ORCID 0000-0002-8056-306X
University of Pittsburgh · USCleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeA high-intensity zone identified on preprocedural MR imaging is known to correlate with pain at provocation lumbar discography. The correlation between enhancing annular fissures and pain at provocation lumbar discography has not been comprehensively evaluated. The purpose of this study was to assess the pain response and imaging features at enhancing annular fissure nonoperated disc levels identified on preprocedural MR imaging with comparison with the high-intensity zone and nonenhancing disc levels in patients referred for provocation lumbar discography. MATERIALS AND

methodsOne-hundred nonoperated discs in 44 patients were retrospectively evaluated for an enhancing annular fissure on sagittal postcontrast T1-weighted pre-discogram MR imaging. Enhancing annular fissure discs were graded on the sagittal T2-weighted sequence (Grade 4: like CSF to Grade 1: negative/barely visible) for high-intensity-zone conspicuity. High-intensity-zone detection was performed independently. In the primary assessment, enhancing annular fissure and high-intensity zones were associated with pain response at provocation lumbar discography. Additional analysis included intradiscal anesthetic response and postdiscogram CT appearance.

resultsThirty-nine discs demonstrated an enhancing annular fissure, with 23/39 demonstrating a high-intensity zone. The presence of a high-intensity zone predicted severe pain (concordant + nonconcordant;

conclusionsConsideration of enhancing annular fissures on preprocedural MR imaging substantially improves the prediction of severe/concordant pain in provocation lumbar discography.

Indexed as

AnestheticsIntervertebral DiscIntervertebral Disc DisplacementLow Back PainHumansLumbar VertebraeMagnetic Resonance ImagingRetrospective StudiesAnesthetics

Identifiers

PMID36549846
PMCPMC9835906
OpenAlexW4312113745

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.