Disc space injection with marcaine as a method to evaluate painful nonunion of an interbody fusion device: a case report.
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.
Ploumis
Avraam
A
Twin Cities Spine Center, 913 E 26th St., Piper Building, Suite 600, Minneapolis, MN 55404, USA. ploumis@med.auth.gr
Pinto
Manuel R
MR
Schellhas
Kurt P
KP
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
D000779:Anesthetics, Local; D002045:Bupivacaine