RESUMO
OBJECTIVE: This study aimed to clarify whether painful annular fissures stimulated during provocation diskography are the likely source of diskogenic pain. DESIGN: A retrospective analysis was conducted of prospectively collected data. SETTING: Multidisciplinary, academic spine center. PATIENTS: The study was completed in a cohort of 28 consecutive patients were enrolled presenting with 6 months duration of axial low-back pain recalcitrant to physical therapy, oral analgesics, and epidural steroid injections and who have diskogenic pain based on history, exam, magnetic resonance imaging, and diskography. INTERVENTIONS: Subjects underwent provocation diskography and analgesic diskography utilizing a balloon-tipped intradiskal catheter allowing intradiskal injection of anesthetic. OUTCOME MEASURES: Visual analog scale, finger-to-floor distance were utilized as outcome measures. RESULTS: 80% of painful intervertebral disks as detected by provocation diskography were sufficiently anesthetized resulting in >50% reduction in low-back pain during analgesic diskography. CONCLUSION: Diskogenic pain is in varying degrees caused by the sensitized nociocepters within annular tears.
