Discogenic Low Back Pain, Diagnostic Criteria Adly Mahmoud Ramadan1,2, Hussein Ahmed Hossameldin1,3, Mahmoud Omyma Sayed4 1Neurosurgery Department, KasrAlainy Medical School, Cairo University, Egypt 2Neurosurgery Department Faculty of Medicine, Beni-Seuf University, Egypt 3Neurosurgery Department Faculty of Medicine, Fayoum University. Egypt 4Radiology Department Faculty of Medicine, Beni-Seuf University, Egypt Online published on 19 August, 2019. Abstract Background Diagnosis of discogenic low back pain is challenging process as a most common cause of low back pain. It is a matter of debate and concern for all health professionals involved, particularly spine surgeons. the aim of this study to establish a specific criteria for diagnosing discogenic LBP. Patients and Method: This our study was carried on 88 patients suffering low back pain suspected to be discogenic in nature which were diagnosed clinically and radiological investigations, clinically We asked patients whether they experienced LBP after sitting too long, while standing after sitting too long, squirming in a chair after sitting too long, and in the standing position with flexion. Also, we examined patient if they have midline tenderness (centralization phenomenon) or not. Rather than classic picture of degenerated disc radiologically as back and bulging discs we analyze mri for high intensity zone in lumbosacral spine MRI. We exclude patient with lumbar spinal stenosis, spondylolisthesis and patient with post-operative lumbar surgery back pain. We analyzed specific criteria clinically and radiologically for diagnosing discogenic LBP. Results We can obtain the precise diagnosis of discogenic low back pain standing on our clinical and radiological criteria. Clinically Medical history and Physical examination: Mainly four criteria LBP after sitting too long All patients experienced LBP after too sitting, it is significant indicator for discogenic LBP. Squirming in a chair after sitting too long There is significant relationship between Squirming during sitting and discogenic back pain, P value is highly significant as it is 0.000 LBP in the standing position with flexion There is significant relationship between LBP in standing with flexion and DLBP, P value is significant as it is 0.014. Centralization phenomenon (CP) All cases have midline tenderness on examination as specific signs or discogenic back pain. We suggested that the CP is a diagnostic indicator of DLBP. Radiologicaliy Magnetic resonance imaging (MRI) is by far the most useful and the most commonly used method for diagnosing DLBP. an MRI of DLBP shows low signal intensity of the disc on T2W, a high-intensity zone (HIZ) at the rear of the disc, and end plate changes. Low signal intensity of the disc on sagittal T2W. However, P-value is not significant, 60% of patients have high intensity zone in MRI L.S.S which considered to be useful in determining symptomatic level. Conclusion All three questions, centralization phenomenon and high intensity zone in MRI Lumbosacral spine were useful and specific for diagnosing discogenic LBP. Top Keywords Dicogenic low back pain-degenerated disc disease-centralization phenomenon. Top |