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MRI and discography of annular tears and intervertebral disc degeneration. A prospective clinical comparison

O L Osti1, R D Fraser

  • 1Spinal Unit, Royal Adelaide Hospital, South Australia.

The Journal of Bone and Joint Surgery. British Volume
|May 1, 1992
PubMed

Insights

Magnetic Resonance Imaging (MRI) and discography were compared for diagnosing low back pain. Discography proved more sensitive than MRI in detecting annular pathology, even when MRI scans appeared normal.

Area of Science:

  • Orthopedics
  • Radiology
  • Spine Surgery

Background:

  • Low back pain is a prevalent condition often associated with intervertebral disc pathology.
  • Accurate diagnostic imaging is crucial for identifying the source of pain and guiding treatment.
  • Magnetic Resonance Imaging (MRI) and discography are commonly used imaging modalities for evaluating lumbar discs.

Purpose of the Study:

  • To correlate the diagnostic findings of MRI and discography in patients experiencing low back pain.
  • To assess the accuracy of each imaging technique in detecting lumbar intervertebral disc abnormalities.

Main Methods:

  • A study involving 33 consecutive patients with low back pain, examining 108 lumbar intervertebral discs.
  • MRI assessment focused on signal intensity and shape in the central disc region.
  • Discography evaluation included contrast material patterns, pressure tolerance, and pain reproduction.

Main Results:

  • All discs with abnormal MRI findings showed altered discographic patterns.
  • However, 18 of 60 discs with normal MRI results exhibited abnormal discograms.
  • Discography identified significant peripheral disc changes not always apparent on MRI, impacting pain perception.

Conclusions:

  • Current discography techniques are more accurate than MRI for detecting annular pathology in the intervertebral disc.
  • A normal MRI does not rule out peripheral disc structural changes that can cause low back pain.
  • Integrating both imaging modalities may offer a more comprehensive assessment of discogenic low back pain.

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