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Chemical radiculitis.

Baogan Peng1, Wenwen Wu, Zhenzhou Li

  • 1Department of Orthopaedics, General Hospital of Armed Police, 69 Yongding Road, 100039 Beijing, China. pengbaogan@163.com

Pain
|September 12, 2006
PubMed
Summary

This study confirms that annular tears in painful discs cause radiating leg pain (radiculopathy). Chemical mediators leaking from disc tears injure nerve roots, explaining pain in discogenic low back pain patients.

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Area of Science:

  • Orthopedics
  • Neurology
  • Pain Medicine

Background:

  • The theory of chemical radiculitis suggests disc tears cause radiating leg pain but lacks clinical proof.
  • Discogenic low back pain with radiculopathy is common, but the exact mechanism remains debated.

Purpose of the Study:

  • To investigate if annular tears in painful discs, confirmed by discography, cause radiating leg pain (radiculopathy).
  • To analyze the correlation between the annular tear location and the side of radiating leg pain.

Main Methods:

  • Studied 42 patients with single-level discogenic low back pain and radiating leg pain.
  • Utilized discography to identify annular tears and monitored electromyogram (EMG) and motor nerve conduction velocity (MNCV) for nerve root injury.

Main Results:

  • Found a significant positive correlation between the site of the annular tear and the side of radiating pain.
  • Observed EMG abnormalities and reduced MNCV on the side of radiating leg pain.
  • Indicated leakage of chemical mediators/inflammatory cytokines from the disc into the epidural space.

Conclusions:

  • Annular tears in painful discs are a likely cause of radiating leg pain in patients with discogenic low back pain.
  • Chemical mediators released through annular tears may injure adjacent nerve roots, forming the primary mechanism for radiculopathy without disc herniation.

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