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