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Related Experiment Videos

The relation between annular disruption on computed tomography scan and pressure-controlled diskography.

Richard Derby1, Byung-Jo Kim, Yung Chen

  • 1Spinal Diagnostics and Treatment Center, Daly City, CA, USA.

Archives of Physical Medicine and Rehabilitation
|August 9, 2005
PubMed
Summary

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Annular disruption, particularly when extending to the outer annulus fibrosus, is strongly linked to low back pain generation. Advanced annular disruption may improve the accuracy of computed tomography (CT) diskography in identifying symptomatic discs.

Area of Science:

  • Spine diagnostics
  • Pain management
  • Radiology

Background:

  • Chronic low back pain is often linked to degenerative disc disease.
  • Accurate identification of symptomatic discs is crucial for effective treatment.

Purpose of the Study:

  • To investigate the correlation between the severity of annular disruption, as visualized by computed tomography (CT) scan, and findings from pressure-controlled manometric diskography.
  • To determine if CT-assessed annular disruption can predict diskographic pain provocation.

Main Methods:

  • A cross-sectional study involving 279 discs from 86 patients with suspected chronic diskogenic low back pain.
  • Annular disruption was graded using CT diskography (grades 0-5).
  • Pressure-controlled manometric diskography was performed, assessing pain provocation at specific pressure thresholds.

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Main Results:

  • A significant correlation (P<.001) was found between the extent of annular disruption and the rate of symptomatic discs.
  • Discs with grade 3 or greater annular disruption accounted for 94.6% of symptomatic discs.
  • The rate of low pressure-sensitive symptomatic discs decreased as annular disruption severity increased.

Conclusions:

  • Annular disruption extending to the outer annulus fibrosus is a primary factor in discogenic pain.
  • CT-assessed disc morphology, specifically severe annular disruption, may enhance the specificity of diskography for diagnosing low back pain.