The textbook of spinal surgery, third edition chapter 43, the use of discography to evaluate lumbar back pin with an eye towards surgical treatment eugene carragee, angus s don. Eugene carragee, md is part of stanford profiles, official site for faculty, postdocs, students and staff information expertise, bio, research, publications, and more. This asymptomatic group was compared with a symptomatic group of patients with respect to the presence of anular highintensity zone and the pain response with discography. Read more latest findings of the stanford discography group. Cohen over at hopkins put out a paper in pain physician journal that refuted this guys studies. State of mind may contribute more to low back pain than. But the bottom line is that it didnt predict who would go on to develop back pain. To investigate the prevalence and significance of a highintensity zone in a group of patients asymptomatic for low back pain, but who had known risk factors for lumbar disc degene. Influence of intradiscal medication on nucleus pulposus.
Eugene carragee was the first to prove that provocative discography may contribute to intervertebral disc degeneration. Carragee is an orthopedic surgeon in palo alto, california and is affiliated with multiple hospitals in the area. Carragee e, tanner c, khurana s, et al false positive lumbar discography in select patients without low back complaints. State of mind may contribute more to low back pain than torn discs. Lumbar provocative discography, including post discography computed. Pdf no transfer of pressure to adjacent discs during human low. Lowpressure positive discography in subjects asymptomatic of. In the multicenter study, 75 patients without serious low.
A gold standard evaluation of the discogenic pain diagnosis as determined by provocative discography carragee. A range of morphologic and psychosocial variables has been suggested as risk factors for serious low back pain lbp illness. They have reported a strong correlation between a high. Although discography is thought by some to be important in diagnosing discogenic back pain. Eugene carragee joined a long, distinguished line of academicians when he published his controversial june 2011 issue of the spine journal tsj. This longterm study proves what many spine specialists have suspected. Course and prognostic factors for neck pain in whiplashassociated disorders wad. Eugene carragee, md, professor of orthopedic surgery, was honored with the north american spine societys outstanding paper award, for his. It was thought that discography could separate the wheat from the chaff, said eugene carragee, md, professor of orthopedic surgery and lead author of the study, which is published in the may 15 issue of spine.
The phenomenon of adjacent segment disease following interbody fusion i. Description of a novel diagnostic technique and report of 3 cases. Eugene j carragees research works stanford university. The rates of falsepositive lumbar discography in select. Lee eugene michaels born michael olsen, november 24, 1945 is an american rock musician who sings and accompanies himself on organ, piano, or guitar. But when the stanford researchers completed a rigorous comparison of the mri and discography results of 96 patients with known risk factors for disc degeneration, they found.
Todd alamin, md, a farbod malek, md, a eugene carragee, md, a and mijung kim, md, phd b, author information article notes. Comparative results and postoperative clinical outcomes alamin, todd. Rhapsody on a theme of paganini, and carmina burana. Eugene carragee, orthopedic surgery, redwood city, ca. Ability of discography to accurately diagnose discogenic. Carragee background context provocative discography, an invasive diagnostic procedure involving disc puncture with pressurization, is a test for presumptive discogenic pain in the lumbar. The rates of falsepositive lumbar discography in select patients without low back symptoms. Although the relative contributions of structural and psychosocial variables are intensely debated, the validity of differing hypotheses has proven difficult to test because the incidence of serious disabling lbp illness is low in healthy subjects. A prospective observational study of patients with low back pain and those without was performed. Three groups were examined including normal, chronic pain, and somatization disorder subjects. One study was an assessment of patients who, like trisha bryant, underwent discography after having had some form of back surgery. Discographic, mri and psychosocial determinants of low. Decision memo for thermal intradiscal procedures cag00387n. Evidencebased management of low back pain in print chapter 30, fusion surgery and disc arthoplasty.
Lumbar highintensity zone and discography in subjects. Miami results of a 10year, prospective study suggest that discography can result in accelerated disc degeneration and herniation. To determine whether discography may cause longterm low back symptoms in selected patients. The authors undertook to study discography in subjects without low back pain but with clinical profiles similar to patients undergoing discography in clinical practice.
Eugene carragee, the director of stanfords orthopedic spine center, who has received four national prizes in recognition of his work. Eugene carragee, md, and a multidisciplinary team of researchers conducted a 10year, matchedcohort surveillance study comparing the incidence of adverse lower back pain lbprelated events, and the need for imaging studies, medical care, hospitalization and surgery among 75 patients who underwent discography, and 75 matched controls who did not. Carragee s mismeasure of rhbmp2 and spine surgeons robin young mon, october 17th, 2011 print this article. A prospective controlled study of patients without low back pain observed after experimental lumbar discography. The use of lumbar discography as a diagnostic tool remains controversial. Psychological stress better predictor of back pain than. Psychological stress better predictor of back pain than standard diagnostic techniques. Eugene carragee, md is part of stanford profiles, official site for faculty, postdocs, students and staff information expertise, bio, research, publications, and.
Does discography cause accelerated progression of degeneration changes in the lumbar disc. Eugene carragee, a spine surgeon at the orthopaedic spine center, treats herniated disc and infection. The problem with carragee is that he is aggressively promoting a point of view and is omitting information which would modify his conclusions. A tenyear matched cohort study spine october 1, 2009, volume 34, number 21, pp 23382345 2009 issls prize winner international society for the study of the lumbar spine this study was done at stanford university school of medicine eugene j. Carragee ej, paragioudakis sj, khurana s 2000c 2000 volvo award winner in. In the early 60s he released the smash hit the duke of earl, a title that became a regular persona for his act. Page 1 of 17 eugene carragee, md professor of orthopaedic surgery at the stanford university medical center clinical offices stanford ortho spine center 420 broadway st pavilion d mc 6415.
Surgeons attending the international society for the study of the lumbar spine issls got the surprise of the decade. Does provocative discography cause clinically important injury to the lumbar intervertebral disc. Does provocative discography cause clinically important. Discography is a diagnostic test used to determine which disc in the spine is causing. Essentially, carragee s previous studies in appropriately performed discography. Provocative discography is an imagingguided procedure in which a contrast agent is. Albums include peter and the wolf young persons guide to the orchestra, rachmaninoff plays rachmaninoff. To address problems with the diagnosis of discogenic low back pain, we have designed a new test, the functional anaesthetic discogram.
Shop for vinyl, cds and more from euge groove at the discogs marketplace. A group of researchers from stanford university led by eugene carragee presented the results of 10 years of study on discography. There are false positive and false negative results in 25% of patients undergoing discography, according to franke, who cited research by eugene carragee, md, of stanford, calif. Discography, functional anaesthetic discogram, discogenic pain, diagnosis. Is lumbar discography a determinate of discogenic low back. Gene chandler born eugene drake dixon on july 6, 1937 is an american singer, songwriter, music producer and record label executive.
Nicknamed the duke of earl or simply the duke, he is best known for his most successful songs duke of earl and groovy situation and his association with the dukays, the impressions and curtis mayfield. He is best known for his powerful soulful voice and his energetic virtuosity on the hammond organ, peaking in 1971 with his top 10 pop hit single, do you know what i mean. Carragee for the prosecution orthopedics this week. Much of the recent research into the limitations of discography as a diagnostic tool was done by dr. Prospective controlled study of the development of lower back pain.
Video chat, send a message, ask a text question, or make a virtual appointment on the doctors virtual practice on healthtap. Some authors have estimated the prevalence of a highintensity zone in a group of symptomatic patients to be 86%. This study suggests that you are at the mercy of the size of the annular tear that produced your herniation. Subjects with no history of low back pain underwent experimental discography. These omissions are clearly troubling to a growing number of experienced and respected north american spine society nass. Eugene carragee, the director of stanfords orthopedic spine center. In its simplest form, provocative discography is an injection into the nucleus of an intervertebral disc, and the test result is determined by the pain response. Per cohen, in the right patient, with the right iasp criteria for discogenic pain. Don lumbar back pain is extremely common, but most cases are selflimiting with no functional deficit. The site facilitates research and collaboration in academic endeavors. Nevertheless, even when diagnostic imaging reveals only degenerative changes, some people become seriously debilitated in the absence of any serious pathology or instability. Music profile for eugene ormandy, born 18 november 1899. Carragee of stanford university and his colleagues tracked nearly 100.