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clinical diagnosis discogenic back pain

Laxmaiah Manchikanti, Amol Soin, Ramsin M Benyamin, Vijay Singh, Frank Je Falco, Aaron K Calodney, Vahid Grami, Joshua A Hirsch
BACKGROUND: The intervertebral disc has been implicated as a major cause of chronic spinal pain based on clinical, basic science, and epidemiological research. There is, however, a lack of consensus regarding the diagnosis and treatment of intervertebral disc disorders. Based on controlled evaluations, lumbar intervertebral discs have been shown to be the source of chronic back pain without disc herniation in 26% to 39% of patients, and in 16% to 53% of patients with pain in the cervical spine...
March 2018: Pain Physician
Standiford Helm Ii, Thomas T Simopoulos, Milan Stojanovic, Salahadin Abdi, Mohamed Ahamed El Terany
BACKGROUND: Discogenic low back is a distinct clinic entity characterized by pain arising from a damaged disc. The diagnosis is clouded by the controversy surrounding discography. The treatment options are limited, with unsatisfactory results from both conservative treatment and surgery. Multiple interventional therapies have been developed to treat discogenic pain, but most have not yet been validated by high quality studies.The best studied treatment for discogenic pain is the use of heat, which has been labeled as thermal intradiscal procedures (TIPs) by the Centers for Medicare and Medicaid Services (CMS)...
September 2017: Pain Physician
Jung Hwan Lee, Sang-Ho Lee
OBJECTIVE: The choice of appropriate treatment of discogenic low back pain (DLBP) frequently is difficult. This study sought to identify the clinical efficacy of percutaneous endoscopic lumbar annuloplasty and nucleoplasty (PELAN) to treat patients with DLBP and to investigate prognostic clinical or radiologic variables. METHODS: Eighty-nine patients with a diagnosis of DLBP who underwent PELAN were included. Numeric Rating Scale (NRS) for back pain, Oswestry Disability Index % (ODI%), and modified Macnab criteria were measured at short-term (3-4 weeks) and long-term follow-up period (at least 12 months) to investigate clinical efficacy of PELAN...
September 2017: World Neurosurgery
Jan Willem Kallewaard, José W Geurts, Michel Terheggen, Chris Terwiel, Alfons Kessels, Maarten van Kleef, Paul C Willems
Background. : A substantial part of low back pain (LBP) originates from degeneration of the intervertebral disc. To confirm the diagnosis of discogenic pain, provocation discography seems the best available tool. However, provocation discography is also considered to be a controversial and subjective test because the patient's personal pain response is the most crucial for the result of the test. Recently, an in vivo porcine study and a study in nine human subjects showed passing of pressure to the adjacent discs during discography...
April 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Massimo Allegri, Silvana Montella, Fabiana Salici, Adriana Valente, Maurizio Marchesini, Christian Compagnone, Marco Baciarello, Maria Elena Manferdini, Guido Fanelli
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety...
2016: F1000Research
Trevor Deleo, Samuel Merotto, Colyn Smith, Kevin D'Angelo
OBJECTIVE: To describe the diagnosis and management of a competitive male basketball player with discogenic low back pain and presence of an old posterior ring apophyseal fracture (PRAF). This case will highlight the importance of early recognition and considerations regarding patient management for this differential of radiating low back pain. CLINICAL FEATURES: A 21-year-old provincial basketball player presented with recurrent radiating low back pain into the left groin and lower limb...
December 2015: Journal of the Canadian Chiropractic Association
Dimitrios K Filippiadis, Alexis Kelekis
Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. Therapeutic armamentarium for low back pain and neuralgia due to intervertebral discs and/or facet joints includes conservative therapy, injections, percutaneous therapeutic techniques and surgical options...
2016: British Journal of Radiology
Paul Verrills, Gillian Nowesenitz, Adele Barnard
BACKGROUND: Between 26% and 42% of chronic low back pain is attributed to internal disc disruption of lumbar intervertebral discs. These prevalence estimates and data characterizing discogenic pain originate largely from research at elite practices, conducted 20 years ago. With few studies since, their concordance with rates in community practice has rarely been addressed. OBJECTIVE: To assess the prevalence and key features of discogenic pain within community-based tertiary practice, and to evaluate the accuracy and clinical utility of discography...
August 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Yasuhiro Oikawa, Yawara Eguchi, Gen Inoue, Kazuyo Yamauchi, Sumihisa Orita, Hiroto Kamoda, Tetsuhiro Ishikawa, Masayuki Miyagi, Miyako Suzuki, Yoshihiro Sakuma, Go Kubota, Kazuhide Inage, Takeshi Saino, Hirotaka Sato, Hiroki Ando, Masatoshi Kojima, Kenichiro Okumura, Yoshitada Masuda, Atsuya Watanabe, Kazuhisa Takahashi, Seiji Ohtori
Recently several authors have reported that diffusion tensor imaging (DTI) might provide a new understanding of sciatica. The purpose of this study was to investigate the clinical feasibility of DTI for the evaluation of lumbar spinal nerve of patients with sciatica associated with lumbar degenerative disorders. Thirty-four patients (25men, mean age63. 3years) with degenerated lumbar disease, 14 patients with lumbar spinal stenosis with foraminal stenosis, 12 with lumbar spinal stenosis without foraminal stenosis, five with lumbar disc herniation, two with discogenic low back pain, and one with spondylolysis who underwent 3...
October 2015: Magnetic Resonance Imaging
Yun Liang, Weibin Shi, Chun Jiang, Zixian Chen, Fubing Liu, Zhenzhou Feng, Xiaoxing Jiang
PURPOSE: A retrospective study was designed to evaluate clinical outcomes and sagittal alignment following single-level unilateral instrumented transforaminal lumbar interbody fusion (TLIF). METHODS: From November 2008 to December 2010, a total of 139 patients, who suffered from single-level lumbar degenerative disease, were included in this study. Forty-seven males and seventy-two females with a mean age of 57.3 years were enrolled. The average follow-up period was 51...
November 2015: European Spine Journal
R Izzo, T Popolizio, P D'Aprile, M Muto
The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD)...
May 2015: European Journal of Radiology
Adem Parlak, Aykut Aytekin, Sedat Develi, Safak Ekinci
Piriformis syndrome is a clinical picture of non-discogenic sciatica caused by compression of the sciatic nerve by the piriformis muscle. It has variable etiologies and the patho-physiology is not fully understood. The major etiology was known to be the spasm, edema and inflammation of the piriformis muscle and sciatic nerve compression of the muscle later on. Patients can be diagnosed immediately with a comprehensive clinical examination and early diagnosis makes the treatment much easier. Diagnosis of the piriformis syndrome, a very rare cause of low back pain, first requires that this syndrome is remembered, and then a differential diagnosis should be performed...
2014: Turkish Neurosurgery
Seiji Ohtori, Gen Inoue, Sumihisa Orita, Yawara Eguchi, Nobuyasu Ochiai, Shunji Kishida, Kazuki Kuniyoshi, Junichi Nakamura, Yasuchika Aoki, Tetsuhiro Ishikawa, Masayuki Miyagi, Hiroto Kamoda, Miyako Suzuki, Masashi Takaso, Tomoaki Toyone, Gou Kubota, Yoshihiro Sakuma, Yasuhiro Oikawa, Kazuhide Inage, Takeshi Sainoh, Kazuhisa Takahashi
STUDY DESIGN: Prospective study of changes in intervertebral disc degeneration after injection of bupivacaine. PURPOSE: To examine whether injection of bupivacaine into human intervertebral discs accelerates their degeneration. OVERVIEW OF LITERATURE: Bupivacaine is commonly used for therapy and diagnosis of discogenic low back pain. However, several in vitro studies have reported toxic effects of bupivacaine to disc cells. We sought to evaluate whether this finding is clinically relevant...
September 2013: Asian Spine Journal
Khalid M Malik, Steven P Cohen, David R Walega, Honorio T Benzon
BACKGROUND CONTEXT: Pain innate to intervertebral disc, often referred to as discogenic pain, is suspected by some authors to be the major source of chronic low back and neck pain. Current management of suspected discogenic pain lacks standardized diagnosis, treatment, and terminology. PURPOSE: In an attempt to determine whether patterns existed that may facilitate standardization of care, we sought to analyze the terminologies used and the various modes of diagnosis and treatment of suspected discogenic pain...
November 2013: Spine Journal: Official Journal of the North American Spine Society
Marco Brayda-Bruno, Marta Tibiletti, Keita Ito, Jeremy Fairbank, Fabio Galbusera, Alberto Zerbi, Sally Roberts, Ellen Wachtel, Yulia Merkher, Sarit Sara Sivan
PURPOSE: One possible source of chronic low back pain is a degenerated intervertebral disc. In this review, various diagnostic methods for the assessment of the presence of degenerative changes are described. These include clinical MRI, a number of novel MRI techniques and nuclear magnetic resonance spectroscopy. METHODS: Non-systematic literature review. RESULTS: Clinical MRI is the most commonly employed technique to determine the general "health status" of the intervertebral disc...
June 2014: European Spine Journal
Jasper M Schellingerhout
The practice guideline 'Invasive treatment of spine related low back pain' was recently released by the Netherlands Society of Anesthesiologists. This guideline evaluates the state of the art regarding the diagnosis and value of invasive treatment for facet joint pain, pain in the sacroiliac joint, coccygodynia, discogenic pain and the 'failed back surgery syndrome'. A new classification system for chronic low back pain was also proposed. The guideline was created in a methodologically sound manner, but the results are disappointing: the evaluated diagnoses remain disputable and the recommendations for the evaluated treatments are mostly based on expert opinion...
2013: Nederlands Tijdschrift Voor Geneeskunde
Sei Fukui, Kazuhito Nitta, Narihito Iwashita, Hisashi Tomie, Shuichi Nosaka, Olav Rohof
BACKGROUND: Discogenic pain is an important cause of low back pain (LBP). We have developed a pulsed radiofrequency (PRF) technique, using Diskit II needles (NeuroTherm, Middleton, MA, USA) placed centrally in the disk, for applying radiofrequency current in the disc (Intradiscal PRF method). OBJECTIVE: The purpose of this study was to investigate the effect of this intradiscal pulsed radiofrequency method in patients with chronic discogenic LBP diagnosed by discoblock, in terms of pain relief and reduction of disability...
July 2013: Pain Physician
Donald S Corenman, Douglas M Gillard, Grant J Dornan, Eric L Strauch
STUDY DESIGN: A retrospective observational study. OBJECTIVE: To assess clinical outcomes, perioperative complications, revision surgery rates, and recombinant human bone morphogenetic protein-2 (BMP-2)-related osteolysis, heterotopic bone, and unexplained postoperative radiculitis (BMPP) in a group of patients treated with BMP-2-augmented transforaminal lumbar interbody fusion (bTLIF) for the homogeneous diagnosis of discogenic pain syndrome (DPS) and to put forth the algorithm used to make the diagnosis...
September 15, 2013: Spine
Leonard Rudolf
BACKGROUND: Sacroiliac (SI) joint pain is a challenging condition to manage as it can mimic discogenic or radicular low back pain, and present as low back, hip, groin and/or buttock pain. Patients may present with a combination of lumbar spine and SI joint symptoms, further complicating the diagnosis and treatment algorithm [1-3]. SI joint pain after lumbar spinal fusion has been reported in the literature. Both clinical and biomechanical studies show the SI joint to be susceptible to increased motion and stress at the articular surface with up to 40-75% of patients developing significant SI joint degeneration after 5 years...
2013: Open Orthopaedics Journal
Laxmaiah Manchikanti, Ramsin M Benyamin, Vijay Singh, Frank J E Falco, Haroon Hameed, Richard Derby, Lee R Wolfer, Standiford Helm, Aaron K Calodney, Sukdeb Datta, Lee T Snook, David L Caraway, Joshua A Hirsch, Steven P Cohen
BACKGROUND: The intervertebral disc has been implicated as a major cause of chronic lumbar spinal pain based on clinical, basic science, and epidemiological research. There is, however, a lack of consensus regarding the diagnosis and treatment of intervertebral disc disorders. Based on controlled evaluations, lumbar intervertebral discs have been shown to be the source of chronic back pain without disc herniation in 26% to 39% of patients. Lumbar provocation discography, which includes disc stimulation and morphological evaluation, is often used to distinguish a painful disc from other potential sources of pain...
April 2013: Pain Physician
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