Search Our Scientific Publications & Authors

J Occup Environ Med 2019 Jan 25. Epub 2019 Jan 25.

ACOEM, 25 Northwest Point Blvd, Suite 700, Elk Grove Village, IL 60007.

Objective: 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

Eur Spine J 2019 Jan 4. Epub 2019 Jan 4.

University of California at San Francisco, San Francisco, CA, USA.

Purpose: The goal of this study was to refine clinical MRS to optimize performance and then determine whether MRS-derived biomarkers reliably identify painful discs, quantify degeneration severity, and forecast surgical outcomes for chronic low back pain (CLBP) patients.

Methods: We performed an observational diagnostic development and accuracy study. Six hundred and twenty-three (623) discs in 139 patients were scanned using MRS, with 275 discs also receiving provocative discography (PD). Read More

J Pain Res 2018 14;11:2853-2857. Epub 2018 Nov 14.

Interventional Spine and Musculoskeletal Care, Virginia iSpine Physicians, PC Virginia Spine Research Institute, Inc Richmond, VA, USA.

Cervical intervertebral disc has long been considered a common source of neck pain. However, the pain caused by the disc itself has not been clearly defined so far, and its diagnosis and treatment has always been controversial. Degenerative cervical disc has a rich supply of nerve fibers, is prone to inflammatory reactions, and is susceptible to pain that can be provoked by disc stimulation or distention, and can be eliminated by block. Read More

World Neurosurg 2018 Dec 6. Epub 2018 Dec 6.

Department of Neurosurgery, The Leon Wiltse Memorial Hospital, Suwon, Korea.

Background: Percutaneous endoscopic lumbar discectomy (PELD) has become popular and is regarded as an alternative treatment for lumbar disc herniation (LDH). Although the indication has expanded with remarkable evolution of the technique, sometimes unexpected experiences have been faced during PELD. De novo disc prolapse was reported for the first time during the PELD. Read More

Int Orthop 2018 Nov 30. Epub 2018 Nov 30.

Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, 5/F Professorial Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China.

Purpose: The purpose of this study was to review the current understanding of high-intensity zones (HIZ) in the lumbar spine with particular attention to its imaging phenotype and clinical relevance.

Methods: A review was conducted of studies related to HIZ. Particular attention was made to imaging phenotypes and classification, and its relationship with discogenic low back pain (LBP). Read More

J Orthop Surg Res 2018 Dec 4;13(1):307. Epub 2018 Dec 4.

Department of Spinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong, People's Republic of China.

Background: It is well known that internal disc disruption (IDD) is accelerated by factors such as aging and injury. High- intensity zone (HIZ) on lumbar MRI is usually considered a marker of painful IDD. However, many painful IDD show no HIZ. Read More

Pain Res Manag 2018 14;2018:6857983. Epub 2018 Aug 14.

Department of Neurosurgery, Nanoori Incheon Hospital, Incheon, Republic of Korea.

Background: Chronic low back pain (CLBP) arising from degenerative disc disease continues to be a challenging clinical and diagnostic problem whether treated with nonsurgical, pain intervention, or motion-preserving stabilization and arthrodesis.

Methods: Fourteen patients with CLBP, greater than 6 months, unresponsive to at least 4 months of conservative care were enrolled. All patients were treated successfully following screening using MRI findings of Modic type I or II changes and positive confirmatory provocative discography to determine the affected levels. Read More

J Orthop Traumatol 2018 Aug 20;19(1):10. Epub 2018 Aug 20.

The Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals, Derby Road, Nottingham, NG7 2UH, UK.

Background: The primary management of pyogenic spondylodiscitis is conservative. Once the causative organism has been identified, by blood culture or biopsy, administration of appropriate intravenous antibiotics is started. Occasionally patients do not respond to antibiotics and surgical irrigation and debridement is needed. Read More

Basic Clin Pharmacol Toxicol 2019 Feb 11;124(2):181-189. Epub 2018 Sep 11.

Department of Neurosurgery, Esencan Hospital, Istanbul Esenyurt University, Istanbul, Turkey.

In the literature, there have been no studies showing clear results on how radio-contrast pharmaceuticals would affect intact disc tissue cells. In this context, it was aimed to evaluate the effects of iopromide and gadoxetic acid, frequently used in the discography, on intact lumbar disc tissue in pharmaco-molecular and histopathological level. Primary cell cultures were prepared from the healthy disc tissue of the patients operated in the neurosurgery clinic. Read More

PLoS One 2018 1;13(8):e0200677. Epub 2018 Aug 1.

The Spine Center of Southern Denmark, Hospital Lillebælt, Middelfart, Denmark.

Background: Previous systematic reviews have reported positive associations between Modic changes (MCs) and low back pain (LBP), but due to their narrow scope and new primary studies, there is a need for a comprehensive systematic review. Our objectives were to investigate if MCs are associated with non-specific LBP and/or activity limitation and if such associations are modified by other factors.

Methods: A protocol for this review was registered at PROSPERO prior to commencing the work (PROSPERO record: CRD42015017350). Read More

Scand J Pain 2010 Oct 1;1(4):186-192. Epub 2010 Oct 1.

University of Newcastle, Newcastle Bone and Joint Institute, Royal Newcastle Centre, Newcastle, NSW 2300, Australia.

Many conditions associated with chronic pain have no detectable morphological correlate. Consequently, the source of pain cannot be established by clinical examination or medical imaging. However, for some such conditions, the source of pain can be established using diagnostic blocks. Read More

J Surg Orthop Adv Spring 2018;27(1):25-32

Department of Orthopaedics, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Lumbar discography (LD) is used to guide surgical decision making in patients with degenerative disc disease (DDD). Its safety and diagnostic accuracy are under contention. This study evaluates LD's efficacy within the workers' compensation (WC) population. Read More

J Spine Surg 2018 Mar;4(1):79-85

Department of Orthopaedics, Iwai Orthopaedic Medical Hospital, Tokyo, Japan.

Background: Percutaneous endoscopic lumbar discectomy (PELD) is a relatively less invasive treatment for lumbar disc herniation (LDH). The present study focused on the transforaminal approach (TFA) and investigated the significance of PELD via this approach for large central LDH.

Methods: LDH that did not show cerebrospinal fluid (CSF) on axial T2-weighted magnetic resonance images was defined as large central LDH. Read More

Medicine (Baltimore) 2018 Apr;97(16):e0509

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.

Rationale: Despite medication, exercise, and medical intervention, many patients complain of persistent discogenic neck pain. To manage discogenic neck pain, we performed intradiscal pulsed radiofrequency (PRF) stimulation in a patient with chronic discogenic neck pain refractory to oral medication and epidural steroid injection.

Patient Concerns: A 26-year-old man presented with a numeric rating scale (NRS) score of 7 for chronic neck pain. Read More

Pain Physician 2018 03;21(2):91-110

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

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. Read More

Eur Spine J 2018 Sep 28;27(Suppl 6):816-827. Epub 2018 Feb 28.

Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey.

Purpose: The purpose of this systematic literature review was to develop recommendations for the assessment of spine-related complaints in medically underserved areas with limited resources.

Methods: We conducted a systematic review and best evidence synthesis of guidelines on the assessment of spine-related complaints. Independent reviewers critically appraised eligible guidelines using the Appraisal of Guidelines for Research and Evaluation-II criteria. Read More

Best Pract Res Clin Rheumatol 2016 12 5;30(6):981-993. Epub 2017 Oct 5.

Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands.

Despite the increased interest in economic evaluations, there are difficulties in applying the results of such studies in practice. Therefore, the "Research Agenda for Health Economic Evaluation" (RAHEE) project was initiated, which aimed to improve the use of health economic evidence in practice for the 10 highest burden conditions in the European Union (including low back pain [LBP] and neck pain [NP]). This was done by undertaking literature mapping and convening an Expert Panel meeting, during which the literature mapping results were discussed and evidence gaps and methodological constraints were identified. Read More

Eur Spine J 2018 01 27;27(1):222-230. Epub 2017 Oct 27.

Translational Centre of Regenerative Medicine TRM, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.

Purpose: This work describes a minimally invasive damage model for ovine lumbar discs via partial nucleotomy using a posterolateral approach.

Methods: Two cadavers were dissected to analyze the percutaneous corridor. Subsequently, 28 ovine had their annulus fibrosus punctured via awl penetration under fluoroscopic control and nucleus pulposus tissue removed via rongeur. Read More

Pain Med 2018 Jul;19(7):1334-1339

Department of Orthopaedic Surgery, Stanford School of Medicine, Redwood City, California, USA.

Objective: To determine if a history of severe episodic low back pain (LBP) correlates with positive discography.

Methods: A retrospective chart review identified patients undergoing discography from January 2012 through February 2016. The review determined if the patient's LBP began or continued with severe disabling episodes (lasting a minimum of two days). Read More

Pain Physician 2017 09;20(6):447-470

Medical Director of interventional spine El Magdi Military Compound Hospitals, Consultant & Head of Physical Medicine and Rehabilitation Department, Assistant Professor at Egyptian Military Medical Academy, Egypt.

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. Read More

Spine J 2018 04 7;18(4):558-566. Epub 2017 Sep 7.

Department of Neurosurgery, c/o Bergman Clinics, Rijksweg 69, 1411 GE Naarden, The Netherlands.

Background Context: Fusion surgery for degenerative disc disease (DDD) has become a standard of care, albeit not without controversy. Outcomes are inconsistent and a superiority over conservative treatment is debatable. Proper patient selection is key to clinical success, and a comprehensive understanding of prognostic tests does not currently exist. Read More

J Korean Neurosurg Soc 2017 Sep 30;60(5):485-497. Epub 2017 Aug 30.

Department of Spine Surgery, Wooridul Spine Hospital, Pohang, Korea.

Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Read More

Scand J Pain 2017 07 21;16:213-220. Epub 2016 Nov 21.

Department of Statistics, Uppsala University, SE-75120 Uppsala, Sweden.

Background: Only two out of the five existing randomized studies have reported better results from fusion surgery for chronic low back pain (CLBP) compared to conservative treatment. In these studies the back symptoms of the patients were described simply as "chronic low back pain". One possible reason for the modest results of surgery is the lack of a description of specified symptoms that might be related to a painful segment/disc, and patient selection may therefore be more or less a matter of chance. Read More

Medicine (Baltimore) 2017 Jul;96(30):e7222

aDepartment of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing bDepartment of Orthopaedics cEducation Department, First Affiliated Hospital of Dalian Medical University, Dalian, the People's Republic of China.

The aim of this study was to analyze the correlation between high-intensity zone (HIZ) on magnetic resonance imaging (MRI) of a lumbar disc and positive pain response assessed by discography for the diagnosis and treatment of discogenic low back pain (LBP). Thirty-seven patients aged 21 to 59 years with chronic LBP but without any neurological symptoms or lumbar disc herniation who underwent MRI and subsequent discography were included in this study. During discography, concordant pain was regarded as positive, whereas discordant pain and no pain were regarded as negative. Read More

Spine (Phila Pa 1976) 2018 04;43(7):467-476

Experimental Tissue Mechanics Laboratory, Department of Chemical and Materials Engineering, University of Auckland, Auckland, New Zealand.

Study Design: A study of mechanically induced herniation in punctured ovine discs followed by structural analysis.

Objective: To investigate whether an annular puncture influences the path that herniation takes by providing direct passage for nucleus through the annulus and therefore whether it increases the risk of acute herniation from overload at the site of damage independent of any longer-term degeneration.

Summary Of Background Data: Ten years after treatment with discography both degenerative changes and frequency of herniation have been shown to increase compared to untreated discs. Read More

Asian Spine J 2017 Jun 15;11(3):380-389. Epub 2017 Jun 15.

Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.

Study Design: Preliminary clinical trial.

Purpose: To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.

Overview Of Literature: PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. Read More

BMC Musculoskelet Disord 2017 04 11;18(1):151. Epub 2017 Apr 11.

Department of Orthopaedic Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, 220-8521, Japan.

Background: Posterior epidural migration of lumbar disc fragments (PEMLDF) is extremely rare. It is often confused with other posterior lesions and is usually diagnosed intraoperatively. We here describe the use of preoperative discography in the diagnosis of PEMLDF. Read More

Pain Med 2018 01;19(1):29-39

Orthopaedic Surgery Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands.

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. Read More

Pain Med 2018 01;19(1):3-8

Los Angeles Minimally Invasive Spine Institute, Los Angeles, California, USA.

Spine J 2017 04;17(4):612-613

Southern Rehabilitation Institute, 29 Byron Street, PO Box 7549, Sydenham, Christchurch 8240, New Zealand.

Spine J 2017 04;17(4):612

Department of Orthopedics and Physical Rehabilitation, UMass Memorial Medical Center, University of Massachusetts Medical School, Spine Center, Memorial Campus, 119 Belmont St, Worcester, MA 01605, USA.

Spine J 2017 04;17(4):610-611

Pain Center, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, Sede Italiano, Via Capelli, 6962 Viganello, Switzerland.

Clin Spine Surg 2017 04;30(3):E219-E225

*Biomedical Engineering †Mechanical & Aerospace Engineering, University of California at Davis, Davis ‡Department of Orthopaedics, School of Medicine, University of California at Davis, Sacramento, CA §Complete Orthopaedic Care, Lincolnshire, IL.

Study Design: An experimental and computational finite element analysis of human lumbar spine discography and its resulting effects on disk biomechanics.

Objective: To characterize the changes in stress and displacement of the human lumbar spine disks after puncture due to discography.

Summary Of Background Data: Discography of the intervertebral disk (IVD) may be used to diagnose pathology of the disk and determine whether it may be a source for chronic back pain. Read More

Ann Intern Med 2017 Apr 21;166(8):547-556. Epub 2017 Mar 21.

From Sorbonne Paris Cité, Université Paris Descartes, Hôpitaux Universitaires Paris Centre, Groupe Hospitalier Cochin, INSERM UMR 1124, UFR Biomédicale des Saints-Pères, Assistance Publique-Hôpitaux de Paris, Hôpital Hôtel-Dieu, INSERM UMR 1153, Université Paris Diderot, Hôpitaux Universitaires Saint-Louis-Lariboisière-Fernand-Widal, Groupe Hospitalier Lariboisière, and Institut Fédératif de Recherche sur le Handicap, Paris, France, and Centre Hospitalier Régional Universitaire de Lille, Hôpital Roger Salengro, Lille, France.

Background: Active discopathy is associated with a specific phenotype of chronic low back pain (LBP). Local inflammation has a role in active discopathy-associated symptoms.

Objective: To assess the efficacy of a single glucocorticoid intradiscal injection (GC IDI) in patients with chronic LBP with active discopathy. Read More

Eur Spine J 2018 01 13;27(1):13-18. Epub 2017 Feb 13.

Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3, Qingchun Road East, Hangzhou, 310016, People's Republic of China.

Purpose: To determine the efficacy of discography and discoblock in the treatment of low back pain (LBP) associated with painful Schmorl's nodes (SNs).

Methods: Between January 2010 and February 2015, 46 patients were studied who had LBP suspected to be secondary to SNs. There were 34 men and 12 women, and mean age was 54. Read More

J Orthop Surg Res 2017 Feb 8;12(1):26. Epub 2017 Feb 8.

Department of Orthopedics, The First People's Hospital of Wenling, No. 190, Taiping Nan Road, Wenling, Zhejiang Province, 317500, People's Republic of China.

Background: This meta-analysis aimed to assess the correlation between the high-intensity zone (HIZ) of a lumbar MRI and discography.

Methods: We conducted an electronic search of the PubMed, MEDLINE, Embase, and ScienceDirect databases from their respective inceptions to October 2016 using the following search terms: "low back pain," "discogenic low back pain," "HIZ or high-intensity zone," and "discography". Relevant journals and conference proceedings were manually searched. Read More

Transl Res 2017 03 28;181:49-58. Epub 2016 Nov 28.

Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Physical Medicine & Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Translational Musculoskeletal Research Center (TMRC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pa. Electronic address:

Spinal conditions related to intervertebral disc (IVD) degeneration cost billions of dollars in the US annually. Despite the prevalence and soaring cost, there is no specific treatment that restores the physiological function of the diseased IVD. Thus, it is vital to develop new treatment strategies to repair the degenerating IVD. Read More

Pain Physician 2016 Nov-Dec;19(8):E1189-E1195

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: Low back pain is a common worldwide health problem and has a significant socioeconomic impact on public health. Internal disc disruption has been considered as the most common cause of low back pain. Various therapies, including interbody fusion, disc replacement, injection therapies, and thermal annular procedures have been utilized for the treatment of discogenic low back pain. Read More

Bone 2017 02 19;95:102-107. Epub 2016 Nov 19.

Spine lab, Department of Orthopedic Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, China. Electronic address:

Clinically, vertebral fractures often occur in the upper lumbar spine and involve the superior endplate of a vertebra (which is immediately caudal to a disc). Knowledge that the cranial endplate of a disc is thicker and has greater bone mineral density (BMD) than the corresponding caudal endplate helps to explain this phenomenon. In this study, we investigated structural differences in vertebral trabeculae on either side of a lumbar disc to provide further insight into vertebral fracture risk. Read More

J Back Musculoskelet Rehabil 2017 ;30(2):383-386

Objective: To present a unique case of guide wire breakage as a rare complication during posterolateral endoscopic lumbar discectomy.

Background: Posterolateral endoscopic lumbar discectomy (PELD) has become a routinely performed minimally invasive spinal procedure. However, several complications of PELD have attracted our concerns, including the intraoperative injury to neural and vascular structures and failure of the surgery. Read More

J Pain Res 2016 31;9:917-924. Epub 2016 Oct 31.

Department of Neurosurgery, E-Da Hospital; Department of Neurosurgery, E-Da Cancer Hospital, College of Medicine, I-Shou University, Kaohsiung, Taiwan.

Background/objective: Internal disk disruption (IDD), an early event of lumbar disk degeneration, is the most common cause of low back pain. Since increased intradiskal pressure (IDP) is associated with symptoms and progression of disk degeneration, unloading a painful disk with an interspinous process device (IPD) is a rational treatment option. The goal of this study was to evaluate the effectiveness of dynamic stabilization with an IPD in the treatment of symptomatic IDD of the lumbar spine. Read More

J Pain Res 2016 31;9:893-898. Epub 2016 Oct 31.

Department of Orthopedic Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.

Purpose: Nucleoplasty is a minimally invasive technique that is considered efficacious in alleviating lumbar disk degenerative low back pain (LBP). The efficacy of nucleoplasty and identified variables that can predict pain relief for nucleoplasty was reported.

Patients And Methods: Between December 2013 and November 2015, 47 nucleoplasty procedures on 47 lumbar disks in 31 consecutive patients were performed. Read More

PLoS One 2016 7;11(11):e0166031. Epub 2016 Nov 7.

Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Purposes: To evaluate the usefulness of our original five questions in a medical interview for diagnosing discogenic low back pain (LBP), and to establish a support tool for diagnosing discogenic LBP.

Materials And Methods: The degenerative disc disease (DDD) group (n = 42) comprised patients diagnosed with discogenic LBP associated with DDD, on the basis of magnetic resonance imaging findings and response to analgesic discography (discoblock). The control group (n = 30) comprised patients with LBP due to a reason other than DDD. Read More

Asian J Neurosurg 2016 Oct-Dec;11(4):450

Department of Neurosurgery Clinic, Ministry of Health Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.

Endoscopic surgery for lumbar disc herniation has been available for more than 30 years. Transforaminal percutaneous endoscopic lumbar discectomy is a well-known, safe, and effective method used for the treatment of the lumbar disc herniation. The published complications of the transforaminal percutaneous endoscopic lumbar discectomy consist of infections, thrombophlebitis, dysesthesia, dural tear, vascular injury, and death. Read More

World Neurosurg 2017 Jan 16;97:8-15. Epub 2016 Sep 16.

Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.

Study Design: Retrospective cohort study.

Objective: To compare the clinical outcomes of patients undergoing anterior lumbar interbody fusion (ALIF) with or without automated pressure-controlled discography (APCD) before the procedure.

Methods: Patients (n = 36) who underwent ALIF for lumbar discogenic back pain between 2008 and 2013 and were followed for more than 6 months were enrolled in this study. Read More

Turk Neurosurg 2017 ;27(4):623-630

Baskent University, Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey.

Aim: Intervertebral disc degeneration can cause severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption unresponsive to conservative medical care. We aimed to evaluate 12-month pain and functional outcomes and predictors of clinical success in patients with discogenic back pain treated with IDET with respect to the Dallas Discogram Scale (DDS). Read More

Spine J 2017 02 1;17(2):218-223. Epub 2016 Sep 1.

University of Kansas School of Medicine-Wichita, Office of Research, 1010 N Kansas, Wichita, KS 67214. Electronic address:

Background Content: Lumbar axial back pain arising from degenerative disc disease continues to be a challenging clinical problem whether treated with nonsurgical management, local injection, or motion segment stabilization and fusion.

Purpose: The purpose of this study was to determine the efficacy of intraosseous basivertebral nerve (BVN) ablation for the treatment of chronic lumbar back pain in a clinical setting.

Study Design: Patients meeting predefined inclusion or exclusion criteria were enrolled in a study using radiofrequency energy to ablate the BVN within the vertebral bodies adjacent to the diagnosed level. Read More

Asian Spine J 2016 Aug 16;10(4):771-5. Epub 2016 Aug 16.

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Preoperative definitive diagnosis of intradural lumbar disc herniation (ILDH) is difficult despite the availability of various neuroradiological investigative tools. We present a case of ILDH diagnosed preoperatively by discography and computed tomography-discography (disco-CT).The patient was a 63-year-old man with acute excruciating right leg pain. Read More