title: Reported pain during lumbar discography as a function of anular ruptures and disc degeneration. A re-analysis of 833 discograms.
abstract: METHODS
  This re-analysis was based on 833 computed tomography/discograms collected from 306 candidates for back surgery.
  
  
  OBJECTIVE
  The goal was to test the hypothesis that outer anular ruptures are the main determinant of the pain of discography.
  
  
  BACKGROUND
  Previous analyses indicated univariate associations of pain with disc degeneration and anular ruptures.
  
  
  METHODS
  If present, pain was classified as "exact", "similar", or "dissimilar" reproduction of the previously experienced pain. For each disc, ruptures and degeneration were separately evaluated by a four-point scale. Multiple logistic regression with random effects was used in the analysis.
  
  
  RESULTS
  Outer anular ruptures were the only predictor of the responses "similar" and "exact". General disc degeneration was the only predictor of the response "dissimilar". There was no effect modification due to gender, age, and spinal level.
  
  
  CONCLUSIONS
  During discography, the outer anulus appears to be the origin of pain reproduction.
authors.affiliation: Institute of Occupational Health, Helsinki, Finland.
authors.forename: G B
authors.initials: GB
authors.lastname: Moneta
authors.forename: T
authors.initials: T
authors.lastname: Videman
authors.forename: K
authors.initials: K
authors.lastname: Kaivanto
authors.forename: C
authors.initials: C
authors.lastname: Aprill
authors.forename: M
authors.initials: M
authors.lastname: Spivey
authors.forename: H
authors.initials: H
authors.lastname: Vanharanta
authors.forename: B L
authors.initials: BL
authors.lastname: Sachs
authors.forename: R D
authors.initials: RD
authors.lastname: Guyer
authors.forename: S H
authors.initials: SH
authors.lastname: Hochschuler
authors.forename: R F
authors.initials: RF
authors.lastname: Raschbaum
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging* / Q000294:innervation; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016015:Logistic Models; D017116:Low Back Pain / Q000209:etiology* / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D010147:Pain Measurement; D014057:Tomography, X-Ray Computed