Original scientific paper

Provocative discography and minimally invasive procedures for the treatment of discogenic pain

LEONARDO KAPURAL ; Department of Pain Management, Cleveland Clinic, Cleveland, Ohio and Department of Anesthesia, University of Zagreb, Croatia
KAYLEA BOUTWELL ; Department of Pain Management, Cleveland Clinic, Cleveland, Ohio and Department of Anesthesia, University of Zagreb, Croatia
KATARINA ŠAKIĆ ; Department of Anaesthesiology, Reanimatology and Intensive Medicine, University Hospital Centar – Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia

Abstract

Diagnosis and treatment of lumbar discogenic pain remains a challenge. It may account for 1/3 of patients with lower back pain. The mechanism of discogenic pain remains unclear, clinical presentation can vary and the MRI may only suggest the presence of internal disc disruption. Provocative discography can provide unique information about the morphology of the disc and remains the only diagnostic test that can relate the changes observed on imaging tests and the patient’s pain. Minimally invasive treatments like
intradiscal biacuplasty or intradiscal electrothermal therapy are likely better alternatives to the currently available surgical options. They are cost effective and may cause fewer side effects. However, the value of most of these therapies has yet to be established. More basic science and clinical studies are needed to prove the clinical efficacy of such minimal invasive treatments. One thing that is clear, however, is that the careful patient selection, based on the present data, significantly improves successes of these procedures.

Keywords

annuloplasty; intradiscal biacuplasty; IDET; provocative discography; discogenic pain; degenerative disc disease

Hrčak ID:

38087

URI

https://hrcak.srce.hr/38087

Publication date:

15.6.2009.

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