Effects on the vertebral end-plate of uncomplicated lumbar discography: an MRI study.
The study aimed to identify and characterise changes occurring in the vertebral end-plate on MRI following uncomplicated lumbar discography. MRI was performed immediately before and within 2 h after uncomplicated lumbar discography in 20 consecutive patients undergoing the study as a precursor to possible spinal fusion. Of these, seven patients underwent a further MRI study at a mean of 72 days after discography (range 19-183 days). The MRI scans were assessed for the presence of any changes in the end-plates prior to and following discography. End-plate changes were identified in eight patients (40%) prior to discography. No new changes in end-plate signal intensity (SI) were identified in either the immediate or delayed MRI studies. The study suggests that any changes occurring in the vertebral end-plate following discography should be considered due to infectious discitis. There is no support for the concept of chemical discitis, chemical irritation of bone or microfracture of subchondral trabeculae as a cause of pain at discography.
Saifuddin
A
A
Department of Radiology, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, UK.
Renton
P
P
Taylor
B A
BA
D000328:Adult; D019072:Antibiotic Prophylaxis; D002444:Cefuroxime / Q000008:administration & dosage; D002511:Cephalosporins / Q000008:administration & dosage; D003287:Contrast Media; D015299:Discitis / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology*; D007404:Intervertebral Disc Chemolysis; D007479:Iopamidol; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography
D002511:Cephalosporins; D003287:Contrast Media; D007479:Iopamidol; D002444:Cefuroxime