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Pain Med 2021 Apr 5. Epub 2021 Apr 5.

Department or Biostatistics, Graduate School of Public Health, University of Pittsburgh, 7123, Public Health, 130 DeSoto Street, Pittsburgh, PA.

Objective: While Provocation Lumbar Discography has been used to identify discs responsible for low back pain, the biomechanical effects of disc injection have received little attention. The purpose of this study was to assess the motion of the Functional Spinal Unit including the Endplate and Facet/Pedicle region during disc injection including comparison between normal and degenerative discs.

Subjects: 91 consecutive patients referred for Discography with chronic low back pain. Read More

Front Med (Lausanne) 2021 18;8:622573. Epub 2021 Mar 18.

Canadian Centre for Regenerative Therapy, Toronto, ON, Canada.

Spinal degenerative joint disease (DJD) is associated with lower back pain (LBP) arising from the degeneration of intervertebral discs (IVD), facet joints, intertransversarii muscles, and interspinous ligaments among other anatomical structures. To circumvent the socioeconomic burdens and often-problematic surgical options imposed by DJD therapy, cell-based biologic modalities like bone marrow aspirate concentrate (BMAC) have been investigated in pre-clinical and clinical settings, mostly for IVD degeneration (IDD), with encouraging outcomes. In this study, we evaluated the differences in therapeutic benefits of BMAC between IVD- and facet joint-originating chronic LBP. Read More

J Mech Behav Biomed Mater 2021 Jun 16;118:104458. Epub 2021 Mar 16.

College of Engineering, Mathematics & Physical Sciences, Physics Building, Stocker Road, Exeter, EX4 4QL, UK.

Needle injection has been widely used in spinal therapeutic or diagnostic processes, such as discography. The use of needles has been suspected in causing mild disc degeneration which can lead to long-term back pain. However, the localised microscopic damage caused by needles has not been well studied. Read More

Spine J 2021 Mar 21. Epub 2021 Mar 21.

Department of Orthopaedic Surgery, Changi General Hospital, Singapore.

Objectives: Pars repair is less explored in adults due to associated disc degeneration with advancing age. The aim of our systematic review was to define optimal characteristics of adults with spondylolysis/grade-I spondylolisthesis suitable for pars repair and evaluate the feasibility, effectiveness, and safety of standard repair techniques in these adults.

Methods: This systematic review is reported in line with PRISMA-P and protocol is registered with PROSPERO (CRD42020189208). Read More

Pain Physician 2021 Mar;24(2):101-116

Department of Physiatry, Hospital for Special Surgery, New York, NY; Regenerative SportsCare Institute, New York, NY.

Background: Interventional spine procedures, such as discography, epidural steroid injections (ESIs), facet joint procedures, and intradiscal therapies, are commonly used to treat pain and improve function in patients with spine conditions. Although infections are known to occur following these procedures, there is a lack of comprehensive studies on this topic in recent years.

Objectives: To assess and characterize infections following interventional spine procedures. Read More

Neuroradiol J 2021 Mar 8:19714009211000622. Epub 2021 Mar 8.

Division of Radiology, University Hospital Policlinico 'Tor Vergata', Italy.

Background And Purpose: Cervical discogenic pain originates from degenerated intervertebral discs and is a common condition in the middle-aged population. Cervical discs may herniate and give compressions to cervical nerves, with pain and functional limitation of the arms. DiscoGel is a device that can be useful in the treatment of cervical disc herniation, with very short operating time and low radiation dose. Read More

Medicine (Baltimore) 2021 Jan;100(3):e24026

Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine, Wuhan, 430079, Hubei.

Rationale: Percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for lumbar disc herniation and postoperative discal pseudocyst (PDP) can rarely develop after PELD.

Patient Concerns: A 30-year-old man experienced low back pain and pain in the right lower extremity for 1 month, which aggravated for 3 days.

Diagnoses: Preoperative CT and MRI showed lumbar disc herniation at the L4/5 level. Read More

Br J Neurosurg 2020 Dec 22:1-6. Epub 2020 Dec 22.

Department of Spine Surgery, the Affiliated Hospital of Qingdao University, Qingdao, China.

We presented a 47-year old male diagnosed as a discal cyst with concurrent isthmic lumbar spondylolisthesis, which was not reported in the literature previously. A cystectomy with two-segmental transforaminal lumbar interbody fusion and instruments was performed. The association between concurrent discal cyst and isthmic spondylolisthesis may be illuminated by excessive strain and focal degeneration of the disc. Read More

J Pain Res 2020 20;13:2125-2129. Epub 2020 Aug 20.

Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan.

Chronic neck pain has a high incidence and prevalence in urban society. Cervical disc-related chronic neck pain with its referred pain is one of the most common causes. Traditionally, pain caused by a cervical disc is diagnosed by fluoroscopy-guided provocative discography. Read More

Pain Med 2020 11;21(11):2719-2725

Department of Anaesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Objective: Discogenic pain is common cause of low back ache and may result in significant morbidity. Platelet-rich plasma (PRP) is an upcoming regenerative therapy that has treatment potential for this condition. The objective of this study was to correlate platelet concentration in intradiscal PRP injection with improvement in low back pain and functional status at three and six months. Read More

Spine (Phila Pa 1976) 2020 Nov;45(22):E1500-E1506

Department of Radiology, Sahlgrenska Academy, University of Gothenburg, Sweden.

Study Design: Retrospective analysis of prospectively collected data.

Objective: The aim of this study was to investigate whether spinal loading, depicted with magnetic resonance imaging (MRI), induces regional intervertebral disc (IVD) differences associated with presence and width of annular fissure and induced pain at discography.

Summary Of Background Data: Annular fissures play a role in low back pain (LBP) but cannot be accurately characterized with conventional MRI. Read More

Spine J 2021 Jan 18;21(1):71-79. Epub 2020 Jul 18.

Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Nadong-Gu, Incheon, 21565, South Korea.

Background Context: The diagnosis of discogenic low back pain (LBP) from disc degeneration of the lumbar spine is often evaluated with discography. Noninvasive, simple screening methods other than invasive discography are useful, as evidence supporting clinical findings and magnetic resonance imaging (MRI) have come to the forefront.

Purpose: To investigate disc height (DH) discrepancy between supine and standing positions on simple radiography to clarify its clinical screening value in individuals with discogenic LBP. Read More

Clin Spine Surg 2020 Jul 8. Epub 2020 Jul 8.

School of Medicine & Medical Science, University College Dublin.

World J Clin Cases 2020 Jun;8(11):2318-2324

Department of Spinal Surgery, the Third Medical Center, PLA General Hospital, Beijing 100039, China.

Background: Chronic neck pain is a common clinical problem. It has long been considered that degenerative cervical disc is an important source of chronic neck pain. In the clinic, cervical discography is thought to be a useful and safe method to distinguish aging discs from pathological discs, and the probability of complications caused by it is really rare. Read More

Pain Med 2020 11;21(11):2738-2742

Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA.

Summary Of Background Data: The literature on cervical provocation discography (C-PD) is sparse. A "Startle Response" during C-PD is a known phenomenon that might be mistaken as an indicator of discogenic pain at the provoked disc level, but this has not been quantitatively described.

Objectives: To determine the incidence of the Startle Response and its concordance/discordance with true-positive C-PD in patients referred for surgical planning or evaluation after ruling out other axial pain generators. Read More

J Vasc Interv Radiol 2020 Apr 29;31(4):686-689. Epub 2020 Feb 29.

Osteo-Articular Imaging Department, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France.

J Orthop Surg Res 2020 Jan 20;15(1):22. Epub 2020 Jan 20.

Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, No. 3, Qingchun Road East, Hangzhou, 310016, People's Republic of China.

Objective: To determine the efficacy of OLIF in the treatment of reoccurring discogenic low back pain (LBP) after discoblock METHODS: We included 108 patients with LBP that was suspected to be discogenic (such as high intensity zone, Schmorl's nodes, Modic changes Type I, etc.), from August 2015 to August 2017. All patients underwent discography, and patients whose LBP was confirmed to be discogenic received discoblock. Read More

J Comput Assist Tomogr 2021 Jan-Feb 01;45(1):146-150

Anne Arundel Medical Center/Annapolis Radiology Associates, Annapolis, MD.

Objective: The objective of this study was to show that degenerative lumbar magnetic resonance imaging findings variably increase discography pain by level.

Methods: Lumbar discography and magnetic resonance imaging of 736 patients were retrospectively reviewed. Univariate/multivariate logistic regressions calculated the odds ratio (OR) (95% confidence interval, P < 0. Read More

J Am Osteopath Assoc 2019 Dec;119(12):814-819

Context: Discogenic low back pain is the most common type of low back pain and is a major cause of morbidity worldwide. Current nonoperative treatment options are limited in efficacy and lack evidence of long-term pain relief; thus, there is an unmet clinical need for an effective treatment for patients with discogenic pain. Amniotic membrane and umbilical cord (AMUC) particulate may be useful in relieving pain and inhibiting the degenerative cascade in patients with discogenic pain by reducing inflammation. Read More

Science 2019 11;366(6468)

Department of Anthropology, Pennsylvania State University, State College, PA 16802, USA.

What is universal about music, and what varies? We built a corpus of ethnographic text on musical behavior from a representative sample of the world's societies, as well as a discography of audio recordings. The ethnographic corpus reveals that music (including songs with words) appears in every society observed; that music varies along three dimensions (formality, arousal, religiosity), more within societies than across them; and that music is associated with certain behavioral contexts such as infant care, healing, dance, and love. The discography-analyzed through machine summaries, amateur and expert listener ratings, and manual transcriptions-reveals that acoustic features of songs predict their primary behavioral context; that tonality is widespread, perhaps universal; that music varies in rhythmic and melodic complexity; and that elements of melodies and rhythms found worldwide follow power laws. Read More

Neuroimaging Clin N Am 2019 Nov 12;29(4):553-561. Epub 2019 Aug 12.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Berman Institute of Bioethics, 550 North Broadway, Suite 301, Baltimore, MD 21205, USA. Electronic address:

In addition to basic image-guided injections, there are many advanced procedures to address the challenges of spine pain. Patients with debilitating symptoms are offered relief, a shorter recovery period, and fewer potential complications. Pain arises from numerous sites along the spine, presenting as spine pain or radiculopathy. Read More

Cureus 2019 Aug 21;11(8):e5453. Epub 2019 Aug 21.

Neurosurgery, University of Louisville School of Medicine, Louisville, USA.

Lumbar discal cyst (LDC) is a rare clinical entity with unclear etiology. Three theories have been proposed to describe the pathogenesis of this condition: (i) a reaction to spinal epidural hematoma; (ii) a pseudomembrane formation that follows the focal annular tear and disc degeneration; and (iii) an inflammatory reaction to the herniated disc fragment. It usually presents with radicular symptoms. Read More

Cardiovasc Intervent Radiol 2020 Jan 13;43(1):94-102. Epub 2019 Aug 13.

Dipartimento di Scienze Neurologiche e Motorie, UOC Neuroimmagini e Neurointerventistica, Azienda Ospedaliera Universitaria Senese, Viale Bracci 16, 53100, Siena, Italy.

Purpose: To retrospectively assess safety and potential effectiveness of percutaneous intervertebral disc coagulation therapy (PDCT) using plasma thermal reaction for the treatment of lumbar and cervical disc hernias resistant to medical therapy.

Materials And Methods: Forty-four patients (age range 18-87 years, mean 52.7) with contained and extruded symptomatic lumbar (N = 48) and cervical (N = 6) disc hernias in the absence of free fragments causing radiculopathy without improvement after 6-week conservative therapy were enrolled. Read More

J Comput Assist Tomogr 2019 Jul/Aug;43(4):568-571

From the Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical System, Baltimore, MD.

Purpose: The purpose of this study was to calculate the positive predictive value (PPV) of lumbar spine magnetic resonance imaging (MRI) findings for a painful disc using provocative discography.

Materials And Methods: Lumbar spine discography records and prediscography MRIs of 736 patients (2457 discs) who underwent discography for diagnostic purposes from 2003 to 2007 were retrospectively reviewed in an Institutional Review Board-exempt and Health Insurance Portability and Accountability Act-compliant protocol. Each level was identified as having high-intensity zone (HIZ) disc, disc protrusion, disc extrusion, or combination (any herniation type), disc bulge, disc degeneration, and spondylolisthesis. Read More

Medicine (Baltimore) 2019 Jul;98(28):e16409

Clinical Neuroscience Institute, Yuquan Hospital, Medical Center, Tsinghua University, Beijing, P.R. China.

Rationale: Coblation of intervertebral disc is an effective and safe minimally invasive technology for treating discogenic pain. The inactivation of neural ingrowth around annulus and tissue ablation and coagulation are currently considered to be the major causes for success of this treatment. However, it has been found by clinical researchers that its long-term clinical outcome is not optimistic. Read More

Spine (Phila Pa 1976) 2019 Oct;44(19):E1161-E1168

Department of Radiology, Mayo Clinic, Rochester, Minnesota.

Study Design: Retrospective matched cohort study.

Objective: To determine if low-pressure lumbar provocation discography (PD) results in long-term accelerated disc degeneration, internal disc disruption, or disc herniation in patients with symptomatic low back pain (LBP).

Summary Of Background Data: Study of subjects without clinically-significant LBP suggests that high-pressure PD may accelerate disc degeneration. Read More

JBMR Plus 2019 May 4;3(5):e10180. Epub 2019 Mar 4.

Leni & Peter W. May Department of Orthopaedics Icahn School of Medicine at Mount Sinai New York NY USA.

Discogenic back pain is multifactorial; hence, physicians often struggle to identify the underlying source of the pain. As a result, discogenic back pain is often hard to treat-even more so when clinical treatment strategies are of questionable efficacy. Based on a broad literature review, our aim was to define discogenic back pain into a series of more specific and interacting pathologies, and to highlight the need to develop novel approaches and treatment strategies for this challenging and unmet clinical need. Read More

Pain Physician 2019 03;22(2):187-198

School of Medicine, Tzu Chi University, Hualien City, Taiwan; Department of Orthopedic Surgery, Buddhist Taichung Tzu-Chi General Hospital, Taiwan.

Background: Controversy is not uncommon in the diagnosis of discogenic low back pain (DLBP) and in the identification of the location of the pain source for the symptomatic disc in patients with DLBP. Various techniques, from minimally invasive procedures to fusion surgery, are used to treat chronic DLBP, but the clinical outcomes are variable. Percutaneous endoscopic discectomy by transforaminal or interlaminar approach is considered to be an effective method to treat DLBP, but the evidence is limited; the lack of clear evidence may be associated with patient selection and surgical technique. Read More

Eur Spine J 2019 05 12;28(5):1014-1022. Epub 2019 Mar 12.

Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.

Purpose: Discography can increase disc degeneration, but the influence of different discography variables on the degeneration of discs has not been reported. The aim of this study was to investigate the effects of discography variables of needle diameter, type of contrast agent and volume of contrast agent on disc degeneration.

Methods: Three separate experiments examined needle diameter, and type and volume of contrast agent. Read More

J Occup Environ Med 2019 04;61(4):e155-e168

American College of Occupational and Environmental Medicine, Elk Grove Village, Illinois.

Objective: The aim of this study was to summarize evidence-based diagnostic guidelines for low back disorders.

Methods: A comprehensive literature review was conducted. A total of 101 articles of high or moderate quality addressing low back disorders diagnostic evaluation met the inclusion criteria. Read More