• Hua-Dong Wang, Shu-Xun Hou, Xiao-Ning Wang, Zhen-Zhou Li, and Wen-Wen Wu.
• Department of Orthopaedics, the First Affiliated Hospital of General Hospital of People's Liberation Army, Beijing 100037, China. ortho@yeah.net
• Zhonghua Wai Ke Za Zhi. 2008 Jul 1;46(13):973-6.

ObjectiveTo study correlation between high intensity zone (HIZ) of lumbar disc and positive pain response on lumbar discography for the diagnosis and treatment of discogenic low back pain.MethodsThirty-seven cases with chronic low back pain without neurologic symptoms and lumbar disc herniation on CT scan underwent lumbar discography and MRI examination. X-ray and CT after discography with positive pain response were analyzed to correlate with HIZ on MRI.ResultsNinety-eight discs underwent discography in 37 patients. Twenty-one discs presented positive pain response; including 10 have HIZ (47.6%). Seventy-seven discs presented negative pain response; including 29 had HIZ (37.6%). The higher grade of annular disruption group had the higher proportion of HIZ on lumbar MRI. There was a positive correlation between HIZ and degree of annular disruption. However, there was no correlation between HIZ and positive pain response on lumbar discography.ConclusionsHIZ on lumbar MRI only can be a filtrated and suggestive image sign and can not replace discography in the diagnosis and treatment of discogenic low back pain.

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