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Percutaneous nucleoplasty and intradiscal electrothermal therapy in the management of lumbar discogenic pain: A retrospective comparative study.
Medicine (Baltimore)
August 2024
Yong-Chul Kim's Pain Clinic, Seoul, Republic of Korea.
Article Synopsis
- Percutaneous lumbar nucleoplasty (PLN) and intradiscal electrothermal therapy (IDET) are both effective treatments for discogenic low back pain (D-LBP), with PLN showing better results.
- In a study of 205 patients, 60.5% reported at least 50% pain relief after 6 months, with higher success rates noted for PLN compared to IDET.
- Factors such as a high-grade Modified Dallas Discogram and treatment at the L3/L4 spinal level predicted better outcomes, while coexisting psychiatric disorders negatively affected treatment success.
[Translated article] Frequency of use of discography findings for the diagnosis of low back pain of discogenic origin. Systematic review of the literature.
Rev Esp Cir Ortop Traumatol
March 2024
Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Article Synopsis
- - The study examines how discography findings are used to diagnose low back pain caused by discogenic issues, analyzing different techniques and interpretations from existing literature.
- - Out of 625 articles reviewed over the past 17 years, 36 studies were included, highlighting that 8 studies relied solely on pain response, while 28 used multiple criteria for a positive discography.
- - The most common criterion for a positive discography was a pain score of 6 or higher on a visual analogue scale, indicating that despite established criteria, varied methods of evaluating these findings remain prevalent.
Establishing a Gold Standard for Noninvasive Identification of Painful Lumbar Discs: Prospective Comparison of Magnetic Resonance Spectroscopy vs Low-Pressure Provocation Discography.
Int J Spine Surg
February 2024
Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA
Article Synopsis
- The study aims to validate the use of magnetic resonance spectroscopy (MRS) as a reliable diagnostic tool for identifying painful lumbar discs, comparing it with the existing gold standard, low-pressure provocative discography (PD).
- Results indicate that MRS-derived measures, specifically NOCISCORE and SI-SCORE, demonstrate high accuracy and reliability in differentiating between painful and non-painful discs, achieving 100% sensitivity and specificity.
- The findings suggest that MRS can effectively predict disc pain and degeneration, providing a non-invasive alternative with potential clinical benefits for patient management.
Finite Element Analysis of Stress Distribution and Range of Motion in Discogenic Back Pain.
Neurospine
June 2024
Department of Physical Medicine & Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea.
Objective: Precise knowledge regarding the mechanical stress applied to the intervertebral disc following each individual spine motion enables physicians and patients to understand how people with discogenic back pain should be guided in their exercises and which spine motions to specifically avoid. We created an intervertebral disc degeneration model and conducted a finite element (FE) analysis of loaded stresses following each spinal posture or motion.
Methods: A 3-dimensional FE model of intervertebral disc degeneration at L4-5 was constructed.
Coexistence of Vertebral and Intervertebral Disc Changes in Low Back Pain Patients-In Depth Characterization with Same Day MRI and CT Discography.
Diagnostics (Basel)
November 2023
Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden.
Article Synopsis
- The study explored the relationships between annular fissures, vertebral and endplate changes, and Modic changes in patients with low back pain using CT and MRI imaging techniques.
- Out of 204 intervertebral discs punctured for evaluation, a high percentage exhibited outer annular fissures, with many being linked to moderate disc degeneration and advanced adjacent degeneration.
- Most Modic changes were associated with significant disc degeneration, but a notable percentage of discs with outer annular fissures did not show severe changes in adjacent vertebrae or endplates.
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