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Related Experiment Videos

Delayed pain response after lumbar discography

S M Lehmer1, M H Dawson, J P O'Brien

  • 1Sierra Spine Institute, Roseville, California.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|January 1, 1994
PubMed
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Delayed pain after lumbar discography can occur when dye leaks through small tears hours later. This phenomenon, often missed, requires careful patient questioning to diagnose accurately.

Area of Science:

  • Pain Management
  • Spinal Diagnostics
  • Radiology

Background:

  • Lumbar discography is an invasive diagnostic procedure.
  • Immediate pain response is typically monitored post-procedure.
  • Delayed symptomatic pain following discography is not well-documented.

Observation:

  • Six patients experienced delayed symptomatic pain after lumbar discography without immediate pain.
  • This occurred in patients with near-normal disc morphology and incomplete annular tears.
  • Dye leakage through these tears 2-12 hours post-injection precipitated the pain.

Findings:

  • Delayed discogenic pain can manifest hours after lumbar discography.
  • Incomplete annular tears allow for delayed dye leakage, causing pain.

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  • The phenomenon may be underreported due to early discharge and lack of specific questioning.

    • Implications:

    • Clinicians must inquire about delayed pain onset post-discography.
    • Recognizing this delayed pain improves diagnostic accuracy.
    • Patient education regarding potential delayed symptoms is crucial.