The treatment of lumbar spinal pain syndromes diagnosed by discography. Lumbar arthrodesis

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 1994-04, Vol.19 (7), p.792-800
• Main Authors: Wetzel, F T, LaRocca, S H, Lowery, G L, Aprill, C N
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Intervertebral Disc - diagnostic imaging; Intervertebral Disc Displacement - diagnostic imaging; Intervertebral Disc Displacement - epidemiology; Intervertebral Disc Displacement - surgery; Low Back Pain - etiology; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Male; Retrospective Studies; Smoking - epidemiology; Spinal Fusion - methods; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0362-2436
• DOI: 10.1097/00007632-199404000-00012

This retrospective review of patients whose discogenic pain syndromes were treated by lumbar arthrodesis was designed to examine the clinical efficacy of this diagnostic modality and analyze possible confounding variables. Clinical outcome was examined with respect to status of the arthrodesis, discographic diagnosis, and demographic variables. Discography continues to be a controversial diagnostic technique for spinal pain syndromes. The morphologic information provided by discography is well known. However, disagreement exists concerning the clinical utility of the pain provoked by this modality. Forty-eight patients were included in this study. In all patients, the chief complaint was low back pain. In all patients, the definitive diagnostic technique was lumbar discography followed by computerized tomographic scanning. All patients underwent lumbar arthrodesis. Data were collected in four categories: 1) demographic characteristics, 2) physical findings, 3) results of diagnostic studies, and 4) characteristics of surgical procedures. Data from these categories were studied with respect to clinical rating and status of the arthrodesis. Overall, 46% were judged to have a satisfactory clinical outcome at final follow-up. Forty-eight percent were judged to have a solid arthrodesis. Based on the results of this study, it appears that discogenic pain syndromes can be treated by arthrodesis.