SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Use and misuse of the sedimentation sign in lumbar spine stenosis.
Synthesis 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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Who cites it
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Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
purposeThe nerve root sedimentation sign (SedSign), introduced in 2010, is a radiological marker for lumbar spinal stenosis (LSS) on MRI. Despite widespread adoption, methodological inconsistencies in its application across studies have raised concerns about validity. This systematic review evaluated the accuracy of SedSign definitions and their impact on conclusions in published research.
methodsPubMed and Google Scholar were searched for articles utilising the SedSign. Definitions and illustrations were independently assessed by two authors against Barz et al.'s original criteria, classified as accurate, inaccurate, or absent. Study conclusions regarding SedSign's clinical and radiological utility were categorised as positive or negative. Journal metrics were analysed for correlation with reported accuracy.
resultsOnly 14 out of 31 studies applied the SedSign definition correctly. Of the 21 studies endorsing its utility, 10 used inaccurate definitions. Notably, 3 of 5 studies dismissing its value also misapplied the criteria. Inaccurate reporting showed no significant association with journal metrics.
conclusionFrequent misapplication of the SedSign in the literature may impact the reliability of research on lumbar spinal stenosis-even in high-impact journals. These findings expose a critical need for stricter adherence to validated radiological criteria and more vigilant peer review. Professional societies may play a key role in the future by developing comprehensive open-access guidelines to support researchers and reviewers in the standardized application of gradings and classifications, thereby enhancing consistency across studies. Ensuring methodological rigour is essential to minimise misleading conclusions with potential clinical implications.
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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.