Disc height discrepancy between supine and standing positions as a screening metric for discogenic back pain in patients with disc degeneration.

The Spine Journal : Official Journal of the North American Spine Society
Seong SonJong Myung Jung

Abstract

The diagnosis of discogenic low back pain (LBP) from disc degeneration of the lumbar spine is often evaluated with discography. Noninvasive, simple screening methods other than invasive discography are useful, as evidence supporting clinical findings and magnetic resonance imaging (MRI) have come to the forefront. To investigate disc height (DH) discrepancy between supine and standing positions on simple radiography to clarify its clinical screening value in individuals with discogenic LBP. Retrospective matched cohort design. Ninety-two patients with early to middle stage disc degeneration (Pfirrmann grade II, III, or IV). Each subject underwent simple radiographs and MRI. Baseline characteristics, including demographic data and MRI findings, and radiological findings, including DH discrepancy, segmental angle, and sagittal balance, were analyzed. DH discrepancy ratio was calculated as (1 - [calibrated DH on standing radiography/calibrated DH on supine radiography]) × 100%. We matched LBP group of 46 patients with intractable discogenic pain (≥7 of visual analog scale scores) confirmed by discography with control group of 46 patients with similar stage disc degeneration with mild LBP (≤4 of visual analog scale scores). Binary ...Continue Reading

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