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Disc Deterioration in Low-Back Syndromes: A Prospective, Multi-Center CT/Discography Study

VANHARANTA, HEIKKI, MD*,∥; GUYER, RICHARD D., MD*; OHNMEISS, DONNA D., MS*; STITH, WILLIAM J., PhD*; SACHS, BARTON L., MD; APRILL, CHARLES, MD; SPIVEY, MARK, MD*; RASHBAUM, RALPH F., MD*; HOCHSCHULER, STEPHEN H., MD*; VIDEMAN, TAPIO, MD; SELBY, DAVID K., MD**; TERRY, ARTHUR, MD††; MOONEY, VERT, MD

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Disc deterioration and pain provocation in different low-back pain syndromes was studied using computed tomography (CT) discography. Data were prospectively collected for 300 patients (816 discs). Patients were classified by their pre-discography diagnosis of disc herniation (DH), degenerated disc (DD), lumbar syndrome (LS), lumbar radicular syndrome (LRS), or other. The CT/discograms were classified by discographic pain response, the amount of degeneration and annular disruption. Eighty-two percent of DH patients, 80% of DD, 56% of LS, and 59% of LRS patients had both positive discographic pain provocation and moderate or severe disc deterioation. The study indicates that intradiscal pathology plays a major role in nonspecific low-back pain syndromes.

* From the Texas Back Institute Research Foundation, Plano, Texas

† From the Concord Orthopaedics, Concord, New Hampshire

‡From the St. Charles Hospital, New Orleans, Louisiana

∥From the University of Texas Southwestern Medical Center, Dallas, Texas

¶ From the University of Oulu, Department of Physical Medicine and Rehabilitation, Oulu, Finland

** From the Spine Education Center, Dallas, Texas

†† From the Lewisville Memorial Hospital, Lewisville, Texas

© Lippincott-Raven Publishers.