Anterior High-Intensity Zone in Lumbar Discs: Prevalence and Association with Low Back Pain. Issue 10 (20th September 2020)

• Record Type: Journal Article
• Authors: Wang, Zi-Xuan; Hou, Zeng-Tao; Hu, You-Gu
• Is Part Of: Pain medicine. Volume 21:Issue 10(2020)
• Page Start: 2111
• Page End: 2116
• Publication Date: 2020-09-20
• Subjects: Intervertebral Disc -- MRI -- High-Intensity Zone -- Anterior Annulus -- Low Back Pain; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1093/pm/pnaa236
• Languages: English
• ISSNs: 1526-2375

Abstract

Abstract: Objectives: To explore the features of high-intensity zone (HIZ) in anterior annulus fibrosus and assess the association of anterior HIZ with low back pain (LBP). Design, Setting, and Subjects: A retrospective study of 5, 940 discs in 1, 188 individuals was conducted. Methods: Subjects' information and LBP symptoms confirmed by an orthopedic surgeon were acquired from the medical record. Magnetic resonance (MR) image reading and analysis were performed by two experienced blinded radiologists. Results: Two hundred eighty individuals exhibited 355 anterior HIZs in 355 discs. The prevalence was 23.57%; 88.45% were located in the inferior part of the annulus fibrosus. It frequently occurred in the middle and upper segments of lumbar spine, especially at L3/4 (45.63%). Of the 355 anterior HIZs, only 79 (22.25%) were consecutive-slides HIZ. Round type (63.38%) was the most common shape of anterior HIZs. The highest prevalence was found in individuals aged 60–69 years. LBP was confirmed in 141 anterior-HIZ individuals. The incidence of LBP in anterior-HIZ individuals was significantly higher than in non-HIZ subjects (50.36% vs 35.24%, χ 2 = 18.314, P < 0.001). Conclusions: Anterior HIZ is a lower-prevalence, age-related sign on lumbar MR images. The spatial distribution of anterior HIZ can be distinguished from posterior HIZ. The number of consecutive anterior HIZ slides might suggest fewer Dallas grade 4 anterior annular disruptions in this sample. Anterior HIZ was correlated with LBP.