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Article: Lumbar high-intensity zones on MRI: imaging biomarkers for severe, prolonged low back pain and sciatica in a population-based cohort

TitleLumbar high-intensity zones on MRI: imaging biomarkers for severe, prolonged low back pain and sciatica in a population-based cohort
Authors
Keywordshigh intensity zone
HIZ
spine
lumbar
pain
Issue Date2020
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/spinee
Citation
The Spine Journal, 2020, Epub 2020-03-01 How to Cite?
AbstractBackground Context: There is often discrepancy between clinical presentation and lumbar magnetic resonance imaging (MRI) findings. Purpose: The purpose of this study was to assess the relationship of high-intensity zones (HIZs) on MRI with low back pain (LBP), sciatica, and back-related disability. Study design: Cross-sectional, population-based Southern Chinese cohort study. Patient sample: Of 1,414 possible participants, data from 1214 participants (453 males, 761 females; mean age of 48.1±6.3 years) were included. Outcome Measures: Presence of single-level, homogeneous multi-level (same type HIZs of morphology and topography) and heterogeneous multi-level (mixed type HIZs of morphology and topography) HIZs and other MRI phenotypes were assessed at each level with T2-weighted 3T sagittal MRI of L1-S1. Associations with LBP, sciatica and Oswestry Disability Index were correlated with HIZ profiles. Results: In all, 718 individuals had HIZs (59.1%). Disc degeneration/displacement were more prevalent in HIZ individuals (p<0.001). HIZ subjects experienced prolonged severe LBP more frequently (39.6% vs 32.5%; p<0.05) and had higher ODI scores (10.7 ± 13.7 vs 8.9 ± 11.3; p<0.05). Posterior multilevel HIZ were significantly associated with prolonged severe LBP (OR:2.18; 95% CI:1.42-3.37) in comparison to anterior only, anterior/posterior or other patterns of HIZ. Multilevel homogeneous or heterogeneous HIZs were significantly associated with prolonged, severe LBP (OR:1.53 to 1.57; p<0.05). Individuals with homogeneous HIZs had a higher risk of sciatica (OR:1.51, p<0.05). Conclusions: This is the first large-scale study to note that lumbar HIZs, and specific patterns therein, are potentially clinically-relevant imaging biomarkers that are independently and significantly associated with prolonged/severe LBP and sciatica. HIZs, especially homogenous multilevel HIZ, should be noted in the global pain imaging phenotype assessment.
Persistent Identifierhttp://hdl.handle.net/10722/281699
ISSN
2019 Impact Factor: 3.191
2015 SCImago Journal Rankings: 1.153

 

DC FieldValueLanguage
dc.contributor.authorTeraguchi, M-
dc.contributor.authorCheung, JPY-
dc.contributor.authorKarppinen, J-
dc.contributor.authorBow, C-
dc.contributor.authorHashizume, H-
dc.contributor.authorLuk, KDK-
dc.contributor.authorCheung, KMC-
dc.contributor.authorSamartzis, D-
dc.date.accessioned2020-03-22T04:18:28Z-
dc.date.available2020-03-22T04:18:28Z-
dc.date.issued2020-
dc.identifier.citationThe Spine Journal, 2020, Epub 2020-03-01-
dc.identifier.issn1529-9430-
dc.identifier.urihttp://hdl.handle.net/10722/281699-
dc.description.abstractBackground Context: There is often discrepancy between clinical presentation and lumbar magnetic resonance imaging (MRI) findings. Purpose: The purpose of this study was to assess the relationship of high-intensity zones (HIZs) on MRI with low back pain (LBP), sciatica, and back-related disability. Study design: Cross-sectional, population-based Southern Chinese cohort study. Patient sample: Of 1,414 possible participants, data from 1214 participants (453 males, 761 females; mean age of 48.1±6.3 years) were included. Outcome Measures: Presence of single-level, homogeneous multi-level (same type HIZs of morphology and topography) and heterogeneous multi-level (mixed type HIZs of morphology and topography) HIZs and other MRI phenotypes were assessed at each level with T2-weighted 3T sagittal MRI of L1-S1. Associations with LBP, sciatica and Oswestry Disability Index were correlated with HIZ profiles. Results: In all, 718 individuals had HIZs (59.1%). Disc degeneration/displacement were more prevalent in HIZ individuals (p<0.001). HIZ subjects experienced prolonged severe LBP more frequently (39.6% vs 32.5%; p<0.05) and had higher ODI scores (10.7 ± 13.7 vs 8.9 ± 11.3; p<0.05). Posterior multilevel HIZ were significantly associated with prolonged severe LBP (OR:2.18; 95% CI:1.42-3.37) in comparison to anterior only, anterior/posterior or other patterns of HIZ. Multilevel homogeneous or heterogeneous HIZs were significantly associated with prolonged, severe LBP (OR:1.53 to 1.57; p<0.05). Individuals with homogeneous HIZs had a higher risk of sciatica (OR:1.51, p<0.05). Conclusions: This is the first large-scale study to note that lumbar HIZs, and specific patterns therein, are potentially clinically-relevant imaging biomarkers that are independently and significantly associated with prolonged/severe LBP and sciatica. HIZs, especially homogenous multilevel HIZ, should be noted in the global pain imaging phenotype assessment.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/spinee-
dc.relation.ispartofThe Spine Journal-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjecthigh intensity zone-
dc.subjectHIZ-
dc.subjectspine-
dc.subjectlumbar-
dc.subjectpain-
dc.titleLumbar high-intensity zones on MRI: imaging biomarkers for severe, prolonged low back pain and sciatica in a population-based cohort-
dc.typeArticle-
dc.identifier.emailCheung, JPY: cheungjp@hku.hk-
dc.identifier.emailCheung, KMC: cheungmc@hku.hk-
dc.identifier.authorityCheung, JPY=rp01685-
dc.identifier.authorityLuk, KDK=rp00333-
dc.identifier.authorityCheung, KMC=rp00387-
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.spinee.2020.02.015-
dc.identifier.hkuros309392-
dc.identifier.volumeEpub 2020-03-01-
dc.publisher.placeNetherlands-

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