ArticleInternational journal of spine surgery2024
Establishing a Gold Standard for Noninvasive Identification of Painful Lumbar Discs: Prospective Comparison of Magnetic Resonance Spectroscopy vs Low-Pressure Provocation Discography.
Article in International journal of spine surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 10 citations in OpenAlex.
- Article
- Article
- Diagnostic Features of Discogenic Low Back Pain: A Narrative Review and Suggested Areas for Future Research and Clinical Practice.JOR spine · 2026Review
- Article
- miR-302a-3p mitigates intervertebral disc degeneration progression through regulating EPHA2.Journal of orthopaedic surgery and research · 2025Article
- The design and rationale of the Biomarkers for Evaluating Spine Treatments trial: a sequential multiple assignment randomized trial.Pain medicine (Malden, Mass.) · 2025Article
- ISSLS Prize in Clinical Science 2025: Cartilage End Plate Defects Precede and Initiate Bony End Plate Defects and Disc Degeneration- An 'Integrated Total End Plate Score' Identify Preclinical Discs at Risk for Degeneration.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 · 2025Article
- A Primer on Anatomy, Biophysics, Pathology, Imaging and Treatment of the Intervertebral Disc and the Anterior Spinal Column: The Discogenic, Intervertebral, Spinal Column (DISC) ASPN Workgroup.Journal of pain research · 2025Article
- A Proposed Diagnostic and Treatment Algorithm for the Management of Lumbar Discogenic Pain.Journal of pain research · 2025Article
- A Self-Polymerizing Mesh of Nano-Tethers for the Mechanical Constraint of Degraded Intervertebral Discs-A Review of 25 Years of Pre-Clinical and Early Clinical Research.Bioengineering (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeVerifying lumbar disc pain can present a clinical challenge. Low-pressure provocative discography (PD) has served as the gold standard, although it is invasive and often a challenge to interpret. We reported that magnetic resonance spectroscopy (MRS) biomarkers accurately predict PD results in lumbar discs and improved outcomes for patients with surgery at positive MRS levels versus nonsurgery. To further substantiate MRS for diagnosing painful discs, we report a prospective comparison of 2 MRS-derived measures: NOCISCORE (pain) and SI-SCORE (degeneration severity).
methodsLumbar MRS and software-based postprocessing (NOCISCAN-LS, Aclarion Inc.) was performed in 44 discs in 14 patients (prospective cohort [PC]). PC data were compared to prior data used to establish the NOCISCORE (training cohort [TC]). The NOCISCORE was converted to an ordinal value (high/intermediate/low; NOCI+/mild/-) and compared against painful (P) versus nonpainful (NP) control diagnosis (PD) for 19 discs where PD was performed in the PC (12 NP; 7 P). Sensitivity, specificity, and positive and negative predictive values were calculated. The SI-SCORE was compared against MRI Pfirrmann Grades for 465 discs in 126 patients (PC plus TC).
resultsFor the PC, MRS (NOCI+/-) compared to PD (P/NP) with an accuracy of 87% and sensitivity and specificity of 100%. The positive and negative predictive values of MRS were 100%. NOCISCOREs were significantly higher for PD+ versus PD- discs for PC and TC (
conclusionThese current data provide prospective confirmation of the predictive value of disc MRS for distinguishing painful discs and for assessing the disc structural integrity. CLINICAL RELEVANCE: NOCISCAN is an adoptable, noninvasive, and objectively quantitative test to improve management of low back pain patients. LEVEL OF EVIDENCE: 2:
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