J Korean Neurosurg Soc.  2009 Jul;46(1):16-22. 10.3340/jkns.2009.46.1.16.

Automated Pressure-Controlled Discography with Constant Injection Speed and Real-Time Pressure Measurement

Affiliations
  • 1Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea.
  • 2Department of Neurosurgery, CHA University, Pocheon, Korea. cistern@cha.ac.kr

Abstract


OBJECTIVE
This study was designed to investigate automated pressure-controlled discography (APCD) findings, to calculate the elastance of intervertebral discs, and to assess the relationship between the calculated elastance and disc degeneration. METHODS: APCD was performed in 19 patients. There were a total of 49 intervertebral discs treated. Following intradiscal puncture, a dye was constantly injected and the intradiscal pressure was continuously measured. The elastance of the intervertebral disc was defined as unit change in intradiscal pressure per fractional change in injected dye volume. Disc degeneration was graded using a modified Dallas discogram scale. RESULTS: The mean elastance was 43.0 +/- 9.6 psi/mL in Grade 0, 39.5 +/- 8.3 psi/mL in Grade 1, 30.5 +/- 22.3 psi/mL in Grade 2, 30.5 +/- 22.3 psi/mL in Grade 3, 13.2 +/- 8.3 psi/mL in Grade 4 and 6.9 +/- 3.8 psi/mL in Grade 5. The elastance showed significant negative correlation with the degree of degeneration (R2 = 0.529, p = 0.000). CONCLUSION: APCD liberates the examiner from the data acquisition process during discography. This will likely improve the quality of data and the reliability of discography. Elastance could be used as an indicator of disc degeneration.

Keyword

Low back pain; Spinal pain; Discography; Diagnosis; Medical device

MeSH Terms

Humans
Intervertebral Disc
Intervertebral Disc Degeneration
Low Back Pain
Punctures
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