title: Discoscopic findings of high signal intensity zones on magnetic resonance imaging of lumbar intervertebral discs.
abstract: A 32-year-old man underwent radiofrequency thermal annuloplasty (TA) with percutaneous endoscopic discectomy (PED) under local anesthesia for chronic low back pain. His diagnosis was discogenic pain with a high signal intensity zone (HIZ) in the posterior corner of the L4-5 disc. Flexion pain was sporadic, and steroid injection was given twice for severe pain. After the third episode of strong pain, PED and TA were conducted. The discoscope was inserted into the posterior annulus and revealed a migrated white nucleus pulposus which was stained blue. Then, after moving the discoscope to the site of the HIZ, a migrated slightly red nucleus pulposus was found, suggesting inflammation and/or new vessels penetrating the mass. After removing the fragment, the HIZ site was ablated by TA. To our knowledge, this is the first report of the discoscopic findings of HIZ of the lumbar intervertebral disc.
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Kosuke
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authors: Sugiura
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Ichiro
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authors: Tonogai
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Tetsuya
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Naoto
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Daisuke
authors: 0000-0001-7868-6733
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authors: Hamada
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Tomohiro
authors: 0000-0002-2060-4157
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authors: Goto
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Yoichiro
authors: 0000-0002-8579-4043
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authors: Takata
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Toshihiko
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Kenji
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authors: Kondo
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
authors: Fumitake
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authors: Tezuka
authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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authors: Department of Orthopedics, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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