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In vivo discography in degenerate porcine spines revealed pressure transfer to adjacent discs.
MedLine Citation:
PMID:  24296483     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
STUDY DESIGN: In vivo experimental porcine study.
OBJECTIVE: To investigate if discography induced pressure increase in adjacent degenerate discs.
SUMMARY OF BACKGROUND DATA: Despite refinements in the past 2 decades, the validity of discography is debated. Discography in healthy pigs has shown that the pressure increase during disc injection transmits to adjacent discs, a potential source for false positive responses.
METHODS: Degeneration in 1 lumbar disc was induced in 10 pigs by drilling a hole through the endplate. Intradiscal pressure was recorded using a 0.36-mm fiber-optic pressure transducer inserted into nucleus pulposus through a 22-gauge needle. The pressure was measured simultaneously in 2 adjacent discs during slow (0.03 mL/s) automated contrast injection into 1 of the discs up to 8 bar (116 psi). Ten adjacent discs were prefilled with contrast from previous discogram. A pressure increase 2 psi or more above baseline was defined as increased pressure in adjacent discs. Pressure was recorded until 15 minutes after injection.
RESULTS: A total of 28 discograms were successfully performed. A pressure increase during injection was detected in 57% (16) of the 28 adjacent discs with mean 3.2 psi (1.7-8.2; standard deviation, 1.8), corresponding to a mean increase above baseline of 11%. Of those 16 adjacent discs, 4 were nondegenerate and 12 degenerate, of which 7 were prefilled. Fifteen minutes after injection, 89% of adjacent discs displayed increase in pressure of mean 14% above baseline.
CONCLUSION: Discography induced pressure increase in adjacent discs in a degenerate disc model, something not reported earlier. If present, also in human spine pressure transmission, may be a potential cause for false positive discography responses.Level of Evidence: 3.
Authors:
Hanna Hebelka; Andreas Nilsson; Lars Ekström; Tommy Hansson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  38     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E1575-82     Citation Subset:  IM    
Affiliation:
*Department of Radiology, Sahlgrenska University Hospital, SU/M, Gothenburg, Sweden; and †Department of Orthopaedics, Sahlgrenska University Hospital, SU/S, University of Gothenburg, Gothenburg, Sweden.
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