The value of high intensity zone in diagnosing lumbar annular disruption before lumbar intradiscal ozone injection

Objective: To investigate the sensitivity, specificity and the clinical value of high intensity zone (HIZ) in the detection of annular disruption before lumbar intradiscal ozone injection. Methods: Retrospective analysis was taken for patients undergone MR and lumbar intradiscal ozone injection from July 2005 to Sep. 2006. The correlation of HIZ with annular disruption found during lumbar intradiscal ozone injection was investigated. Results: One hundred and thirteen discs in 68 patients with back and/or radicular pain were examined with lumbar intradiscal ozone injection. Seventy one disc with HIZ were identified on MRI with annular disruption found during lumbar intradiscal ozone injection. The sensitivity and specificity of HIZ in diagnosing annular disruption were 90.9% and 85% respectively, with a positive correlation between HIZ and the lumbar annular disruption. Conclusions: HIZ on MRI is a marker for annular disruption, with high sensitivity and specificity; and helpful for treatment approach selection. (authors)