BACKGROUND The diagnostic evaluation of patients with presumed discogenic low back pain is controversial; recent studies have brought the specificity of the traditional technique, provocative lumbar discography, into question. One of the explanations for the relative lack of predictability in treatment outcomes for patients with discogenic low back pain may be a corresponding lack of certainty ...

The patho-anatomy in an aging spine is partly defined by Rauschning's anatomic cryosections. Theories of pain generation and principles of minimally invasive spine surgery are suggested by close examination of these specimens. If the visualized patho-anatomy can be studied in vivo in a partially sedated patient by spinal probing, spinal pain can be better understood, and rational endoscopic tre...

MATERIAL We report our experience between May 1996 and May 2003 with 2200 patients affected by low back pain or sciatica due to herniated disk treated by intradiscal and intraforaminal oxygen-ozone injection. The patients received medical and physical therapy before treatment for at least 2 months; the patients with conus-cauda syndrome and hyperalgesic sciatica were excluded. We never performe...

Seventeen patients with intractable sciatica due to prolapse of a lumbar disc, treated by intradiscal injection of chymopapain (chemonucleolysis) were studied. Analysis of serial 24 hour urine collections showed a significant increase in urinary glycosaminoglycan after chemonucleolysis. This was not detected in four patients undergoing routine discography. Enzymic analysis of urinary glycosamin...

The purpose of this study was to determine whether the anatomic position of a lumbar disc herniation has any significant effect on the clinical outcome of lumbar discectomy. Between January 1988 and March 1993, 80 patients with simple disc herniations underwent lumbar discectomy for herniated nucleus pulposus. We reviewed preoperative computed tomography scans after discography and magnetic res...

Lumbar disc disease characterized by symptomatic disc herniation or typical sciatica is a major challenge for health care. Its prevalence was studied as part of the Mini-Finland Health Survey in a sample of over 7000 Finnish adults. A diagnosis of lumbar disc syndrome based on medical history, symptoms, and standardized physical examination was made for 5.1% of the men and for 3.7% of the women...

High-intensity zone (HIZ) was originally described as a high-intensity signal on T2-weighted magnetic resonance (MR) images, located in the posterior annulus fibrosus, clearly separated from the nucleus pulposus. Among symptomatic patients with low back pain, HIZ is present in 28-59% of cases. In morphologically abnormal discs, high sensitivity and specificity of 81% and 79%, respectively, were...

OBJECTIVE To evaluate the efficacy of intradiscal methylene blue (MB) injection in patients with chronic discogenic low back pain. METHOD Twenty patients with discogenic low back pain (4 males, 16 females; mean age 45.6 years) refractory to conservative management were recruited. All subjects underwent MB injection in target lumbar intervertebral discs confirmed by provocative discography. Th...

Introduction: The aim of this study was to study if lidocaine exhibits a toxic effect on bovine-derived nucleus pulposus (NP) cells in an in vitro study. Provocative discography is utilized by some physicians in the evaluation of back pain that may be discogenic in origin, and some variations of the technique suggest infiltration of lidocaine into the outer anulus fibrosus prior to intradiscal ...