Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation.
METHODS
The correlation between discogenic lumbar pain and disc morphology was investigated by using magnetic resonance imaging and discography.


OBJECTIVE
To assess the various pathologic parameters seen on magnetic resonance imaging in patients with discogenic lumbar pain and to correlate them with observations on discography.


BACKGROUND
Although numerous previous studies on the subject have been performed, the correlations between various pathologic findings on magnetic resonance imaging and pain reproduction by provoked discography have not been explained fully.


METHODS
One hundred and one lumbar discs in 39 patients were studied with magnetic resonance imaging and pain provocation discography. When pain reproduction under discography was concordant, various pathologic parameters on magnetic resonance imaging were analyzed by three statistical parameters to determine the associated magnetic resonance imaging findings.


RESULTS
Radial tears commonly are demonstrated on magnetic resonance imaging in discs with concordant pain on discography. The presence of these tears is not a reliable predictor of a painful disc on discography. Although a high-intensity zone on T2-weighted images is a relatively reliable predictor of pain, the statistical values were lower than those in previous studies. Massive degeneration and severe disc height loss were rare in this population. These findings were good predictors of pain on disc injection.


CONCLUSIONS
Although the lumbar intervertebral discs with posterior combined anular tears are likely to produce pain, the validity of these signs for predicting discogenic lumbar pain is limited.
Ito
M
M
Department of Orthopaedics, Hokkaido University School of Medicine, Sapporo, Japan.
Incorvaia
K M
KM
Yu
S F
SF
Fredrickson
B E
BE
Yuan
H A
HA
Rosenbaum
A E
AE
D000328:Adult; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis*; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011859:Radiography; D015203:Reproducibility of Results