Abstract
AbstractThe literature reports that 39% of chronic lower back pain may be attributed to intervertebral disc derangement. However, definitive diagnosis of discogenic lower back pain (DLBP) remains challenging. Clinical examination may be normal and the correlative utility of magnetic resonance imaging findings such as the high intensity zone is controversial. Researchers have identified a complex interplay of degenerative, immunohistological, and biomechanical overload factors as causative. Due to difficulties in diagnosis through physical examination and imaging alone, provocative discography is still the gold standard for surgical planning, by measuring intradiscal pressure, finding extradiscal dye extravasation, and by reproducing concordant pain against controls. This remains so, despite the known sequelae of latent acceleration of disc degeneration following the procedure. Lumbar interbody fusion (LIF), in its various forms, is the traditional surgical management for intractable pain from DLBP. Howeve...
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