|
Fig 3. Patient is a 50-year-old woman with long-standing lower back pain, not associated with injury (VAS score, 10/10), with an outside MR imaging study demonstrating mild degenerative disk changes at L4-5 and significant degenerative disk changes at L5-S1 but no evidence of disk protrusion. The patient is currently being evaluated further by provocation diskography for potential surgical treatment. After 2.5-mL contrast injection at L5-S1, her severe and concordant lower back pain reproduced (VAS score, 9–9.5/10). Partial improvement in her concordant pain occurred after intradiskal administration of 1-mL lidocaine.
A, Frontal diskographic fluoroscopic image obtained after contrast injection at L5-S1 demonstrates fragmentation and degenerative changes of both nuclear and annular components (arrow), without evidence of contrast leakage.
B, Axial postdiskographic CT image at L5-S1 demonstrates degenerative disk changes with fragmentation and tears of the annulus (arrows) but without any epidural contrast leakage.
|