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Analysis of the Correlation Among Age, Disc Morphology, Positive Discography and Prognosis in Patients With Chronic Low Back Pain.

Kim SM, Lee SH, Lee BR, Hwang JW - Ann Rehabil Med (2015)

Bottom Line: Discs with similar or concordant pain were classified as positive.There was a higher correlation between general degeneration and age, as compared with annular disruption and age.Age and grade of general degeneration did not affect the prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine & Rehabilitation, Korea University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To investigate the correlation among age, disc morphology, positive discography, and prognosis in patients with chronic low back pain.

Methods: A total of 183 intervertebral discs in 72 patients with chronic low back pain were studied. Discography was performed using a pressure-controlled manometric technique. The pain reaction during discography at each level was recorded as follows: no pain, dissimilar pain, similar pain, or concordant pain. Discs with similar or concordant pain were classified as positive. All the examined discs were assessed morphologically using axial computed tomography imaging. The grade of general degeneration and annular disruption of the discs were assessed according to the Dallas discogram description (DDD). Intradiscal injection of steroid was tried for patients with symptomatic disc identified during provocative discography and who did not consent to surgical operation.

Results: There was a higher correlation between general degeneration and age, as compared with annular disruption and age. Higher general degeneration and annular disruption grades had higher positive rates of discography. However, annular disruption alone was independently associated with positive discography. Age and grade of general degeneration did not affect the prognosis.

Conclusion: The grade of general degeneration was associated with age, but it was not correlated with positive discography and prognosis. In addition, high grade of annular disruption correlated with positive discography.

No MeSH data available.


Related in: MedlinePlus

Annular disruption of Dallas discogram description. (A) Grade 0, none. (B) Grade 1, into inner annulus. (C) Grade 2, into outer annulus. (D) Grade 3, beyond outer annulus.
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Figure 2: Annular disruption of Dallas discogram description. (A) Grade 0, none. (B) Grade 1, into inner annulus. (C) Grade 2, into outer annulus. (D) Grade 3, beyond outer annulus.

Mentions: The axial images of post-discography lumbar CT were used to grade the extent of general degeneration and annular disruption according to the Dallas discogram description (DDD) [12]. General degeneration was rated as 0 when normal and progressed to 3 when contrast filled more than half of the annulus (Fig. 1). Annular disruption was graded as 0 when normal and progressed to 3 when contrast escaped beyond outer annulus (Fig. 2). Annular fissure toward the anterior of disc was not considered during rating of annular disruption.


Analysis of the Correlation Among Age, Disc Morphology, Positive Discography and Prognosis in Patients With Chronic Low Back Pain.

Kim SM, Lee SH, Lee BR, Hwang JW - Ann Rehabil Med (2015)

Annular disruption of Dallas discogram description. (A) Grade 0, none. (B) Grade 1, into inner annulus. (C) Grade 2, into outer annulus. (D) Grade 3, beyond outer annulus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496504&req=5

Figure 2: Annular disruption of Dallas discogram description. (A) Grade 0, none. (B) Grade 1, into inner annulus. (C) Grade 2, into outer annulus. (D) Grade 3, beyond outer annulus.
Mentions: The axial images of post-discography lumbar CT were used to grade the extent of general degeneration and annular disruption according to the Dallas discogram description (DDD) [12]. General degeneration was rated as 0 when normal and progressed to 3 when contrast filled more than half of the annulus (Fig. 1). Annular disruption was graded as 0 when normal and progressed to 3 when contrast escaped beyond outer annulus (Fig. 2). Annular fissure toward the anterior of disc was not considered during rating of annular disruption.

Bottom Line: Discs with similar or concordant pain were classified as positive.There was a higher correlation between general degeneration and age, as compared with annular disruption and age.Age and grade of general degeneration did not affect the prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine & Rehabilitation, Korea University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To investigate the correlation among age, disc morphology, positive discography, and prognosis in patients with chronic low back pain.

Methods: A total of 183 intervertebral discs in 72 patients with chronic low back pain were studied. Discography was performed using a pressure-controlled manometric technique. The pain reaction during discography at each level was recorded as follows: no pain, dissimilar pain, similar pain, or concordant pain. Discs with similar or concordant pain were classified as positive. All the examined discs were assessed morphologically using axial computed tomography imaging. The grade of general degeneration and annular disruption of the discs were assessed according to the Dallas discogram description (DDD). Intradiscal injection of steroid was tried for patients with symptomatic disc identified during provocative discography and who did not consent to surgical operation.

Results: There was a higher correlation between general degeneration and age, as compared with annular disruption and age. Higher general degeneration and annular disruption grades had higher positive rates of discography. However, annular disruption alone was independently associated with positive discography. Age and grade of general degeneration did not affect the prognosis.

Conclusion: The grade of general degeneration was associated with age, but it was not correlated with positive discography and prognosis. In addition, high grade of annular disruption correlated with positive discography.

No MeSH data available.


Related in: MedlinePlus