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Subgroups of positive discs on discography
Conor O'Neill1, Marina Kurgansky
1Spinal Diagnostics & Treatment Center, Daly City, CA, USA. coneill@sbcglobal.net
Spine
|September 30, 2004
Summary
Pressure-controlled discography (PCD) in chronic low back pain (CLBP) patients identified two distinct disc pain threshold groups: contact-sensitive and pressure-sensitive. This method helps quantify pain thresholds and estimate false-positive results in discography.
Area of Science:
- Spine surgery
- Pain management
- Diagnostic imaging
Background:
- Disc pain threshold distribution characteristics can identify patient subgroups.
- Chronic low back pain (CLBP) diagnosis can be challenging.
Purpose of the Study:
- To define the distribution of disc pain thresholds in CLBP patients.
- To identify a potential false-positive subgroup using an analytical model.
Main Methods:
- Retrospective study of pressure-controlled discography (PCD) in 253 CLBP patients (838 discs).
- Determined disc pain thresholds and analyzed distributions using an analytical model.
- Compared results with published data from asymptomatic individuals.
Main Results:
- Identified two distinct disc pain threshold groups: contact-sensitive (CS) and pressure-sensitive (PS).
- CS discs provoked pain upon contact (0 psi); PS discs required internal pressure (> 0 psi).
- Established probabilities for false-positive discs at various pressure thresholds (e.g., 14 psi = 10%, 25 psi = 50%).
Conclusions:
- Pressure-controlled discography (PCD) allows quantification of disc pain thresholds.
- PCD enables estimation of the probability of false-positive results in discography.
- Implementing pressure control is crucial for accurate disc pain assessment.