Related Experiment Video
Updated: Dec 31, 2025
Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability
Published on: July 25, 2025
The Association Between Magnetic Resonance Imaging Disc Pathology and Provocative Discography at the Lumbar Level
Greer Waldrop1, Graham Trent1, Azar P Dagher2
1From the School of Medicine, University of Maryland.
Objective:
The objective of this study was to show that degenerative lumbar magnetic resonance imaging findings variably increase discography pain by level.
Methods:
Lumbar discography and magnetic resonance imaging of 736 patients were retrospectively reviewed. Univariate/multivariate logistic regressions calculated the odds ratio (OR) (95% confidence interval, P < 0.05).
Results:
L3-4 multivariate regression OR for a degenerative disc is 9.9; for bulge, 10.9; for annular tear, 38.9; for herniation, 51.5; and for degenerative facet, 2.158. Endplate changes were not significant. L4-5 OR for a degenerative disc is 4.52; for bulge, 13.74, for tear, 19.13; for herniation, 28.65; for endplate edema, 3.47; and fatty change, 3.84. Degenerative facet ORs were not significant. L5-S1 OR for a degenerative disc is 6.86; for bulge, 5.65; for tear, 40.56; and for herniation, 77.98. Endplate changes and degenerative facet OR's were not significant.
Conclusions:
Advancing degeneration increases pain at L5-S1 followed by L3-4. Endplate signal is significant only at L4-5.
