title: Disc space injection with marcaine as a method to evaluate painful nonunion of an interbody fusion device: a case report.
abstract: BACKGROUND
  Discography has been successfully used to distinguish painful from asymptomatic intervertebral discs.
  
  
  OBJECTIVE
  To report a case of chronic back pain following two-level interbody and posterolateral fusion in the lumbar spine that was evaluated with marcaine injection into the disc space.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A patient with chronic back pain after a two-level anteroposterior lumbar fusion was evaluated. A complete description of the history, physical examination, and relevant radiographic images along with a brief review of the pertinent literature are included.
  
  
  RESULTS
  Injection of marcaine into the area of previous interbody fusion resolved the painful symptoms, and surgery confirmed the nonunion.
  
  
  CONCLUSIONS
  In cases of interbody lumbar fusion with questionable solidity, marcain injection within the disc space can help in the assessment of the source of pain even at the intervertebral spaces with cages.
authors.affiliation: Twin Cities Spine Center, 913 E 26th St., Piper Building, Suite 600, Minneapolis, MN 55404, USA. ploumis@med.auth.gr
authors.forename: Avraam
authors.initials: A
authors.lastname: Ploumis
authors.forename: Manuel R
authors.initials: MR
authors.lastname: Pinto
authors.forename: Kurt P
authors.initials: KP
authors.lastname: Schellhas
mesh_terms: D000328:Adult; D000779:Anesthetics, Local; D002045:Bupivacaine; D002908:Chronic Disease; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology* / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000473:pathology* / Q000601:surgery; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis*; D012086:Reoperation; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine