SynthesisJournal of orthopaedic surgery and research2023
The correlation between the lumbar disc MRI high-intensity zone and discogenic low back pain: a systematic review and meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 19 citations in OpenAlex.
- Article
- 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
- The clinical role of lncRNA PRKG1-AS1 in lumbar disc degeneration and its mechanism in regulating inflammation and ferroptosis via miR-218-5p.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
- Comparative Outcomes of Lumbar Platelet-Rich Plasma Injection Versus Conservative Treatment for Chronic Discogenic and/or Radicular Pain: A Retrospective Cohort Study.Biomedicines · 2026Article
- Clinical significance and regulatory mechanism of miR-4284 in lumbar intervertebral disc degeneration.Journal of orthopaedic surgery and research · 2026Article
- Advances and challenges in AI-assisted MRI for lumbar disc degeneration detection and classification.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
- The pivotal role and intervention strategies of BMAL1 mediated circadian clock dysregulation in intervertebral disc degeneration.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026Review
- Mechano-immune interactions in musculoskeletal aging: Mechanisms and translational perspectives.Theranostics · 2026Review
- A Comparative Analysis of Ultrasound versus Fluoroscopy-Guided Transforaminal Endoscopic Lumbar Discectomy: Protocol for a Randomized Clinical Trial Targeting Lumbar Disc Herniation.Journal of pain research · 2026Article
- Diagnostic evidence in suspected discogenic low back pain: a pain-source attribution perspective.Frontiers in medicine · 2026Review
- Degenerative Disease of Intervertebral Disc: A Narrative Review of Pathogenesis, Clinical Implications and Therapies.Bioengineering (Basel, Switzerland) · 2025Review
- Clinical and Economic Outcomes of Intradiscal Injection of Condoliase for a Treatment of Lumbar Disc Herniation with Severe Low Back Pain: A Multicenter Study.Spine surgery and related research · 2025Article
- Exploring extracellular vesicles as novel therapeutic agents for intervertebral disc degeneration: delivery, applications, and mechanisms.Stem cell research & therapy · 2025Review
- ASIC1a mediated nucleus pulposus cells pyroptosis and glycolytic crosstalk as a molecular basis for intervertebral disc degeneration.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2025Review
- Fundamentals of intervertebral disc degeneration and related discogenic pain.World journal of orthopedics · 2025Article
- Enhancing LDD diagnosis with YOLOv9-AID: simultaneous detection of pfirrmann grading, disc herniation, HIZ, and Schmorl's nodules.Frontiers in bioengineering and biotechnology · 2025Article
- Correlation analysis of spine-pelvis parameters and age with lumbar paravertebral muscle degeneration in middle age and older adults.American journal of translational research · 2025Article
- Pitfalls in the Diagnosis and Treatment of Low Back Pain in an Elite Para-athlete Successfully Treated by Transforaminal Full-endoscopic Discectomy with Thermal Annuloplasty: A Case Reports.NMC case report journal · 2025Article
- Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to investigate the correlation between the MRI high-intensity zone (HIZ) and the pathogenesis of discogenic low back pain.
methodsLiterature from PubMed, EMBASE, Cochrane Library, Science Direct, China Knowledge Network, Wanfang Database, and China Biomedical Literature Database was searched until August 2023. Cohort studies including patients with low back pain who underwent lumbar spine MRI and discography, as well as the results evaluating the correlation between HIZ and discography for morphological changes in the disc and pain replication phenomena, were included in the analysis. The literature that met the inclusion criteria was screened, and the methodological quality of the included studies was evaluated. Meta-analysis of the extracted data was performed by using RevMan 5.1.1.
resultsIn total, 28 reports were included in this meta-analysis. There was a statistically significant correlation between a positive HIZ and abnormal disc morphology in discography (OR 28.15, 95% CI [7.38, 107.46], p < 0.00001). Patients with HIZ-positive discs had a significantly higher incidence of consistent pain (71.0%, 969/1365) than those with HIZ-negative imaging (29.0%, 1314/4524) (OR 7.71, 95% CI [5.29, 11.23], p < 0.00001).Segments that were HIZ-positive and had abnormal disc morphology had a higher incidence of consistent pain (86.1%, 230/267) than HIZ-negative subjects (32.2%, 75/233) (OR 14.09, 95% CI [2.12, 93.48], p = 0.006).
conclusionA positive MRI T2-weighted image of the lumbar disc with HIZ indicates disc degeneration. In addition, HIZ may be a specific indicator for the physical diagnosis of discogenic low back pain. A more advanced degree of disc degeneration on the basis of HIZ positivity corresponded to a greater probability of discography-induced consistent pain, whereas the degree of disc degeneration on the basis of HIZ negativity was less correlated with contrast-induced consistent pain.
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Registered trials
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