Abstract
To explore value of different radiographic indexes in the diagnosis of discogenic low back pain (LBP). A total number of 120 cases (60 patients diagnosed with discogenic LBP and 60 healthy people) were retrospectively analysed to identify factors in the diagnosis of discogenic LBP by using univariate and multivariate analyses. A receiver operating characteristic (ROC) curve was drew to show the predictive accuracy of the finally enrolled factors. Among all the included patients, 60 were strictly admitted in the discogenic LBP group while the other 60 were enrolled in the control group. Five results shows significant differences between discogenic LBP and control groups, including Cobb angle, lumbar stability, height of the disc, Modic change and High intense zone (HIZ) based on the results of univariate analysis; lumbar stability, Modic change and HIZ show high value in the diagnosis of lumbar discogenic pain based on the multivariate logistic analysis. The ROC curve shows that good diagnostic accuracy was obtained from the enrolled diagnostic factors including lumbar stability (Angular motion, more than 14.35°), Modic change and HIZ.
Highlights
low back pain (LBP) has been considered to be the top leading cause for years lived with disability globally, while lumbar discogenic pain is the main cause of LBP [1,2,3]
Five results shows significant differences between discogenic LBP and control groups, including Cobb angle, lumbar stability, height of the disc, Modic change and High intense zone (HIZ) based on the results of univariate analysis; lumbar stability, Modic change and HIZ show high value in the diagnosis of lumbar discogenic pain based on the multivariate logistic analysis.The receiver operating characteristic (ROC) curve shows that good diagnostic accuracy was obtained from the enrolled diagnostic factors including lumbar stability (Angular motion, more than 14.35°), Modic change and HIZ
Patients with lumbar disc herniation or lumbar spinal stenosis were excluded (n = 275). 120 patients were assessed for eligibility . 60 patients with positive results of provocation discography were selected as study group and 60 patients with negative results of provocation discography were regarded as control group (Figure 1)
Summary
LBP has been considered to be the top leading cause for years lived with disability globally, while lumbar discogenic pain is the main cause of LBP [1,2,3]. There are a lot of factors which are correlated to the discogenic LBP, such as lumbar spine stability, degree of lumbar intervertebral disc (IVDs) degeneration and pathobiology of Modic changes [7,8]. Studies using animal discogenic pain models and specimens from degenerated human IVDs have provided insights into the pathomechanisms of discogenic LBP, some one believed that painful discs are characterized by a confluence of innervation, inflammation factors [9,10]. Spinal imaging modalities have been widely used to diagnose discogenic LBP, including MR, computed tomography (CT), plain radiography (X-rays), myelography, and CT-myelography, while provocative discographys is the gold standard [11,12,13]. Analysis of imaging measurement in the diagnosis of discogenic LBP still remains absent. We carried out this research aiming to characterize a carefully selected cohort of the patients with discogenic LBP and to elucidate the factors in the diagnosis of discogenic LBP by using univariate and mulitivariate analyses
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