High-Intensity Zones on MRI of the Cervical Spine in Patients : Epidemiology and Association With Pain and Disability
STUDY DESIGN: Retrospective cohort study.
OBJECTIVES: This study aimed to address the prevalence, distribution, and clinical significance of cervical high-intensity zones (HIZs) on magnetic resonance imaging (MRI) with respect to pain and other patient-reported outcomes in the setting of patients that will undergo an anterior cervical discectomy and fusion (ACDF) procedure.
METHODS: A retrospective cohort study of ACDF patients surgically treated at a single center from 2008 to 2015. Based on preoperative MRI, HIZ subtypes were identified as either traditional T2-hyperintense, T1-hypointense ("single-HIZs"), or combined T1- and T2-hyperintense ("dual-HIZs"), and their level-specific prevalence was assessed. Preoperative symptoms, patient-reported outcomes, and disc degeneration pathology were assessed in relation to HIZs and HIZ subtypes.
RESULTS: Of 861 patients, 58 demonstrated evidence of HIZs in the cervical spine (6.7%). Single-HIZs and dual-HIZs comprised 63.8% and 36.2% of the overall HIZs, respectively. HIZs found outside of the planned fusion segment reported better preoperative Neck Disability Index (NDI; P = .049) and Visual Analogue Scale (VAS) Arm (P = .014) scores relative to patients without HIZs. Furthermore, patients with single-HIZs found inside the planned fusion segment had worse VAS Neck (P = .045) and VAS Arm (P = .010) scores. In general, dual-HIZ patients showed no significant differences across all clinical outcomes.
CONCLUSIONS: This is the first study to evaluate the clinical significance of HIZs in the cervical spine, noting level-specific and clinical outcome-specific variations. Single-HIZs were associated with significantly more pain when located inside the fusion segment, while dual-HIZs showed no associations with patient-reported outcomes. The presence of single-HIZs may correlate with concurrent spinal pathologies and should be more closely evaluated.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Global spine journal - 12(2022), 5 vom: 18. Juni, Seite 829-839 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nguyen, Austin Q [VerfasserIn] |
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| Links: |
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| Themen: |
Cervical |
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| Anmerkungen: |
Date Revised 05.08.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1177/2192568220966328 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM317705067 |
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| 100 | 1 | |a Nguyen, Austin Q |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a High-Intensity Zones on MRI of the Cervical Spine in Patients |b Epidemiology and Association With Pain and Disability |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Revised 05.08.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a STUDY DESIGN: Retrospective cohort study | ||
| 520 | |a OBJECTIVES: This study aimed to address the prevalence, distribution, and clinical significance of cervical high-intensity zones (HIZs) on magnetic resonance imaging (MRI) with respect to pain and other patient-reported outcomes in the setting of patients that will undergo an anterior cervical discectomy and fusion (ACDF) procedure | ||
| 520 | |a METHODS: A retrospective cohort study of ACDF patients surgically treated at a single center from 2008 to 2015. Based on preoperative MRI, HIZ subtypes were identified as either traditional T2-hyperintense, T1-hypointense ("single-HIZs"), or combined T1- and T2-hyperintense ("dual-HIZs"), and their level-specific prevalence was assessed. Preoperative symptoms, patient-reported outcomes, and disc degeneration pathology were assessed in relation to HIZs and HIZ subtypes | ||
| 520 | |a RESULTS: Of 861 patients, 58 demonstrated evidence of HIZs in the cervical spine (6.7%). Single-HIZs and dual-HIZs comprised 63.8% and 36.2% of the overall HIZs, respectively. HIZs found outside of the planned fusion segment reported better preoperative Neck Disability Index (NDI; P = .049) and Visual Analogue Scale (VAS) Arm (P = .014) scores relative to patients without HIZs. Furthermore, patients with single-HIZs found inside the planned fusion segment had worse VAS Neck (P = .045) and VAS Arm (P = .010) scores. In general, dual-HIZ patients showed no significant differences across all clinical outcomes | ||
| 520 | |a CONCLUSIONS: This is the first study to evaluate the clinical significance of HIZs in the cervical spine, noting level-specific and clinical outcome-specific variations. Single-HIZs were associated with significantly more pain when located inside the fusion segment, while dual-HIZs showed no associations with patient-reported outcomes. The presence of single-HIZs may correlate with concurrent spinal pathologies and should be more closely evaluated | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a HIZ | |
| 650 | 4 | |a MRI | |
| 650 | 4 | |a cervical | |
| 650 | 4 | |a degenerative | |
| 650 | 4 | |a disc | |
| 650 | 4 | |a disease | |
| 650 | 4 | |a high-intensity zones | |
| 650 | 4 | |a low back pain | |
| 650 | 4 | |a neck pain | |
| 700 | 1 | |a Harada, Garrett K |e verfasserin |4 aut | |
| 700 | 1 | |a Leverich, Kayla L |e verfasserin |4 aut | |
| 700 | 1 | |a Khanna, Krishn |e verfasserin |4 aut | |
| 700 | 1 | |a Louie, Philip K |e verfasserin |4 aut | |
| 700 | 1 | |a Basques, Bryce A |e verfasserin |4 aut | |
| 700 | 1 | |a Tao, Youping |e verfasserin |4 aut | |
| 700 | 1 | |a Galbusera, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Niemeyer, Frank |e verfasserin |4 aut | |
| 700 | 1 | |a Wilke, Hans-Joachim |e verfasserin |4 aut | |
| 700 | 1 | |a An, Howard S |e verfasserin |4 aut | |
| 700 | 1 | |a Samartzis, Dino |e verfasserin |4 aut | |
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