Orthopedics (77)

Abstract

Can discography cause long‐term back symptoms in previously asymptomatic subjects? (Stanford University School of Medicine, Stanford, CA) Spine 2000;25:1803–1808.This prospective controlled study aimed to determine whether discography might cause long‐term low back symptoms in selected patients. Twenty‐six patients without preexisting low back pain were observed for 1 year after lumbar discography to determine the effects of lumbar discography in 3 experimental groups: 10 patients who had remote cervical spine surgery with excellent results (pain‐free group); 10 patients who had the same surgery with poor results (chronic pain group); and 6 patients who had primary somatization disorders. Two control groups were also observed: a group of patients with somatization disorder who were similarly evaluated but without discography and a group of patients with low back pain observed for 1 year after discography without surgery. In the 3 experimental groups (no back pain before discography) no subject with normal psychometric testing had persistent pain after discography (0/11), whereas 6 (40%) of the 15 with abnormal psychometric tests results reported significant new low back pain. None of the pain‐free group (0/10), 20% of the chronic neck pain group (2/10), and 66% of the somatization group (4/6) continued to have significant back pain 1 year after injection. Psychological testing and occupational disability strongly predicted continued pain after discography. The control groups had no significant change in low back symptomatology during the year of observation. Conclude that discography in a subject group without low back pain, but with significant emotional and chronic pain problems may result in reports of significant back pain for at least 1 year after injection. Subjects with normal psychometric test results had no reports of significant long‐term back pain after discography.