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Table 1 Study characteristics

From: Diagnostic accuracy of diagnostic imaging for lumbar disc herniation in adults with low back pain or sciatica is unknown; a systematic review

Author Design and setting Patients Target condition (prevalence) Level of measurement Index test Note
Aejmelaus 1984 [47] Retrospective, secondary care, Finland 200 patients; 54.5% male (of n = 200), mean age 43.8 (range 14–82) Diagnosis of disc herniation (68.4%) Patient level; 95 patients on lumbar spine surgery Myelo: contrast medium metrizamide (Amipaque, 170-200 mg iodine/ml)  
Bernard 1994 [44] Prospective study, secondary care, USA 33 patients persistent/ recurring symptoms after lumbar surgery: 61% male; age range: 23–74 years Recurrent lumbar disc herniation (69.7%) Patient level MRI: 0.5Tesla MRI (29 patients) or 1.5Tesla MRI (4 patients) including spin echo T1 and T2 sagittal images 2 observers assessed each patient = 66 responses
Birney 1992 [45] Prospective study, secondary care, USA 90 patients with LBP or radicular pain refractory to ≥3 months of conservative, non operative treatment; 57 underwent surgery; 53% males age range 20–71 years Lumbar disc herniation and/ or degenerative disc disease (98.7%) Disc level; 76 disc levels of 57 operated patients MRI: 0.35Tesla MRI. Axial images and sagittal images  
Bischoff 1993 [43] Retrospective study, secondary care, USA 57 patients for lumbar spine surgery; 51% male; age range: 20–79 years HNP (48.6%) Disc level; 72 levels assessed of 47 operated patients Myelo: infusion of 16 ml Omnipaque 180 solution MRI: 1.5Tesla MRI; sagittal and axial T1 and T2 weighted images  
Chawalparit 2006 [46] Prospective study, secondary care, Thailand 123 LBP patients and suspected lumbar disc herniation; 50% male; age range: 21–60 years Lumbar disc herniation (69.7%) Patient level; 33 operated patients MRI: full protocol; 1.5Tesla; sagittal T1 weighted images, sagittal T2 weighted images and axial T2 weighted images 54 patients treated conservatively and 36 lost to follow up; excluded from analysis
Claussen 1982 [34] Prospective, Secondary care, Germany 77 patients with suspected disc prolapse, 46.7% male; Disc prolapse (92.3%) Patient level; 26 patients operated CT: Somatom II, 10s; 125 kV, 460mHz  
Myelo: metrizamide (amipaque)
Firooznia 1984 [35] Prospective, Secondary care, Germany 100 patients who underwent surgery for sciatica: 61% male, mean age 49 (19–76) years Disc prolapse (90.5%) Disc level; 116 levels assessed of 100 patients CT: GE 8800 CT/T, 25 cm circular calibration, 250-400 mA, 120 kVp, 9.6 s  
Forristall 1988 [36] Prospective, Secondary care, USA 32 patients with suspected lumbar disc herniation: 78% male, mean age 45 (22–74) years HNP with neural compression (77.4%) Disc level; 31 levels assessed in 25 operated patients CT: Picker 1200 Synerview, 14 cm, 65 mA, 130 kV, 5 mm slice thickness, 5 ml of Amipaque 180 mg/ml  
MRI: 1.5Tesla MRI sagittal T1 and T2 weighted images; Proton density and T2 weighted axial images
Gillstrom 1986 [37] Prospective, Secondary care, Sweden 90 patients with suspected herniated discs 59.4% male, age range 23–74 years Lumbar disc herniation Patient level; 37 operated patients CT: General Electris GT/T 8800 unit  
Myelo: Metrizamide contrast solution
Jackson 1989 I [38] Prospective, Secondary care, USA 124 patients with LBP and leg pain, refractory to conservative management: 70% male, mean age 43 (21–76) years HNP: protruded, extruded, and sequestrated disc (54.1%) Disc level; 231 levels assessed of 124 patients CT: Siemens Somatom, 5 mm slice thickness with 1 mm overlap  
Myelo: infusion of 14 ml metrizamide (Amipaque) of 180 mg iodine/ml
Jackson 1989 II [39] Prospective, Secondary care, USA 59 patients with LBP and leg pain refractory to conservative management: 56% male, mean age 40 (18–70) years HNP: protruded, extruded, and sequestrated disc (49.2%) Disc level; 120 levels assessed of 59 patients CT: Siemens Somatom, 5 mm slice thickness with 1 mm overlap using bone and soft tissue settings  
Myelo: infusion of 14 ml iohexol (Omnipaque) of 180 mg iodine/ml
MRI: 1.5Tesla MRI Sagittal T1 and T2 weighted images and axial T1 weighted images
Milano 1991 [40] Prospective, Italy 40 surgical patients; 57.5% male; mean age 43 (range 27–60) Lumbar intervetrebral disc disease (50%) Disc level; 80 discs examined CT: Somaton DR CT scan, slices of 4 mm  
Schaub 1989 [41] Retrospective, Secondary care, Swiss 29 patients with recurring symptoms after lumbar disk surgery: 48% male, mean age 49 (SD:13) years HNP (62.1%) Patient level CT: No information  
Myelo: No information
Schipper 1987 [42] Prospective, Secondary care, Netherlands 235 patients with radiating leg pain, referred to the neurosurgical department: 61% male, mean age 43 years Lumbar disc herniation: (83.8%) Patient level CT: Philips Tomoscan 350, 200 As, 120 kV, 3 mm slice thickness  
Myelo: 15 ml Iopamiro 200LBP: low back pain
  1. HNP Hernia nucleus pulposis