Lumbar Disc High-intensity Zone

Introduction: A high intensity zone (HIZ) in intervertebral disc (IVD) of lumbar spine is a high intensity signal located in the annulus fibrosus of T2-weighted magnetic resonance (MR) imaging. There is limited information on the prevalence of HIZ in lumbar spine in Nepalese population. The aim of this cross-sectional study was to identify the prevalence of HIZ according to the age and its correlation with degenerated disc, disc herniation & bulge and modic changes. Methods: This was a prospective MR based study in 268 patients (1380 IVD) with LBP, Leg pain or numbness. The prevalence and correlation of HIZ , degenerated disc, disc herniation and bulge and modic change was evaluated in 5 age groups (<20, 20-39, 40-59, 60-79, >80). Results: The prevalence of HIZ in patients with LBP was 30.5%. Total 1340 IVD were examined out of which122 had HIZ, 742 had degenerated disc, 688 had disc herniation and bulge and 182 had modic changes. Degenerated disc was observed in 95% (116/122) and 51.3% (626/1218) of disc with and without HIZ respectively. Disc herniation and bulge were observed in 98.3% (120/122) and 46.6% (568/1218) of the disc with and without HIZ, respectively. Modic changes were observed in 11.4% (14/122) and 13.7% (168/1218) of disc with and without HIZ respectively. Conclusions: There was statistically significant correlation between existence of HIZ and degenerated discand disc herniation and bulge, but there was no correlation with the existence of modic changes.

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Lumbar disc high-intensity zone: the value and significance of provocative discography in the determination of the discogenic pain source

European Spine Journal ◽

10.1007/s005860050006 ◽

2000 ◽

Vol 9 (1) ◽

pp. 36-41 ◽

Cited By ~ 113

Author(s):

K. S. Lam ◽

D. Carlin ◽

R. C. Mulholland

Keyword(s):

High Intensity ◽

Lumbar Disc ◽

Discogenic Pain ◽

High Intensity Zone ◽

Provocative Discography

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Point of View: Lumbar Disc High-intensity Zone: Correlation of Magnetic Resonance Imaging and Discography

Spine ◽

10.1097/00007632-199601010-00019 ◽

1996 ◽

Vol 21 (1) ◽

pp. 86 ◽

Cited By ~ 2

Author(s):

Jay A. Kaiser

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

High Intensity ◽

Lumbar Disc ◽

Point Of View ◽

Resonance Imaging ◽

High Intensity Zone

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Correlation of Low Back Pain to a High-Intensity Zone of the Lumbar Disc in Indian Patients

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700214 ◽

2009 ◽

Vol 17 (2) ◽

pp. 190-193 ◽

Cited By ~ 8

Author(s):

Ketan C Pande ◽

Ketan Khurjekar ◽

Vilas Kanikdaley

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Visual Analogue Scale ◽

High Intensity ◽

Analogue Scale ◽

Lumbar Disc ◽

Low Back ◽

Pain Drawing ◽

Observer Reliability ◽

High Intensity Zone

Purpose. To assess the correlation between low back pain and a high-intensity zone (HIZ) of the lumbar disc in Indian patients. Methods. 200 patients with low back and/or leg pain underwent magnetic resonance imaging of the lumbosacral spine. The location and severity of pain and disability were assessed using the pain drawing, visual analogue scale, and Oswestry Disability Index, respectively. The inter-observer reliability was assessed using the kappa statistic. Results. The prevalence of an HIZ was 13% and 17% according to observers A and B, respectively. The inter-observer reliability was fair (κ=0.64, p<0.005). The presence of an HIZ did not correlate with low back pain according to the pain drawing, visual analogue scale, and Oswestry Disability Index. According to the pain drawing data, the sensitivity, specificity, and positive predictive values of an HIZ to low back pain were 11%, 82%, and 62%, respectively. Conclusion. The presence of an HIZ is not diagnostic of a disrupted and painful disc, and should be interpreted together with other prevailing symptoms and clinical findings.

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