Psychological stress better predictor of back pain than. Does provocative discography cause clinically important. Psychological stress better predictor of back pain than standard diagnostic techniques. Lee eugene michaels born michael olsen, november 24, 1945 is an american rock musician who sings and accompanies himself on organ, piano, or guitar. The site facilitates research and collaboration in academic endeavors. 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. Carragee ej, paragioudakis sj, khurana s 2000c 2000 volvo award winner in. These omissions are clearly troubling to a growing number of experienced and respected north american spine society nass. This important question was answered by the famous researcher in spine surgeon, eugene carragee of stanford, who performed an ingenious and awardwinning human experiment, which was published in 2009.
Evidencebased management of low back pain in print chapter 30, fusion surgery and disc arthoplasty. Eugene carragee, a spine surgeon at the orthopaedic spine center, treats herniated disc and infection. 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. To determine whether discography may cause longterm low back symptoms in selected patients. Gene chandler born eugene drake dixon on july 6, 1937 is an american singer, songwriter, music producer and record label executive. A group of researchers from stanford university led by eugene carragee presented the results of 10 years of study on discography. Music profile for eugene ormandy, born 18 november 1899. Decision memo for thermal intradiscal procedures cag00387n. A prospective observational study of patients with low back pain and those without was performed. Eugene carragee joined a long, distinguished line of academicians when he published his controversial june 2011 issue of the spine journal tsj.
The rates of falsepositive lumbar discography in select patients without low back symptoms. In the multicenter study, 75 patients without serious low. Shop for vinyl, cds and more from euge groove at the discogs marketplace. Nevertheless, even when diagnostic imaging reveals only degenerative changes, some people become seriously debilitated in the absence of any serious pathology or instability. Albums include peter and the wolf young persons guide to the orchestra, rachmaninoff plays rachmaninoff. 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. The use of lumbar discography as a diagnostic tool remains controversial. This was an excellent paper written by the world famous, volvo award winning, issls winning professor eugene carragee md, orthopedic surgeon, stanford university school of medicine. Prospective controlled study of the development of lower back pain. Lumbar provocative discography, including post discography computed. The rates of falsepositive lumbar discography in select. Is lumbar discography a determinate of discogenic low back. Carragee of stanford university and his colleagues tracked nearly 100.
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. 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. Eugene carragee, orthopedic surgery, redwood city, ca. Rhapsody on a theme of paganini, and carmina burana. Discography is a diagnostic test used to determine which disc in the spine is causing. The authors undertook to study discography in subjects without low back pain but with clinical profiles similar to patients undergoing discography in. Eugene carragee, md, professor of orthopedic surgery, was honored with the north american spine societys outstanding paper award, for his. Some authors have estimated the prevalence of a highintensity zone in a group of symptomatic patients to be 86%. 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. Eugene carragee, the director of stanfords orthopedic spine center. Lowpressure positive discography in subjects asymptomatic of.
Course and prognostic factors for neck pain in whiplashassociated disorders wad. Miami results of a 10year, prospective study suggest that discography can result in accelerated disc degeneration and herniation. Three groups were examined including normal, chronic pain, and somatization disorder subjects. Eugene j carragees research works stanford university. 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. Does provocative discography cause clinically important injury to the lumbar intervertebral disc. Ability of discography to accurately diagnose discogenic. Disc degeneration can be induced either by mechanical trauma caused by the puncturing needle or as a pharmacological effect of.
Although discography is thought by some to be important in diagnosing discogenic back pain. Cohen over at hopkins put out a paper in pain physician journal that refuted this guys studies. Pdf no transfer of pressure to adjacent discs during human low. They have reported a strong correlation between a high. In the early 60s he released the smash hit the duke of earl, a title that became a regular persona for his act. The problem with carragee is that he is aggressively promoting a point of view and is omitting information which would modify his conclusions. Eugene carragee, md is part of stanford profiles, official site for faculty, postdocs, students and staff information expertise, bio, research, publications, and. Per cohen, in the right patient, with the right iasp criteria for discogenic pain. To address problems with the diagnosis of discogenic low back pain, we have designed a new test, the functional anaesthetic discogram. Carragee is an orthopedic surgeon in palo alto, california and is affiliated with multiple hospitals in the area. Surgeons attending the international society for the study of the lumbar spine issls got the surprise of the decade. Essentially, carragee s previous studies in appropriately performed discography.
But the bottom line is that it didnt predict who would go on to develop back pain. Description of a novel diagnostic technique and report of 3 cases. State of mind may contribute more to low back pain than torn discs. Eugene carragee, md is part of stanford profiles, official site for faculty, postdocs, students and staff information expertise, bio, research, publications, and more. 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 s mismeasure of rhbmp2 and spine surgeons robin young mon, october 17th, 2011 print this article. 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. However, provocation discography is also considered to be a.
Read more latest findings of the stanford discography group. Carragee e, tanner c, khurana s, et al false positive lumbar discography in select patients without low back complaints. Does discography cause accelerated progression of degeneration changes in the lumbar disc. Subjects with no history of low back pain underwent experimental discography. The authors undertook to study discography in subjects without low back pain but with clinical profiles similar to patients undergoing discography in clinical practice. 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. Comparative results and postoperative clinical outcomes alamin, todd. Chapter 16 discography eugene carragee, md provocative discography is a diagnostic test sometimes used to evaluate the disc as a potential source of persistent back and neck pain syndromes. This study suggests that you are at the mercy of the size of the annular tear that produced your herniation. Discography, functional anaesthetic discogram, discogenic pain, diagnosis.
Provocative discography is an imagingguided procedure in which a contrast agent is. State of mind may contribute more to low back pain than. Carragee background context provocative discography, an invasive diagnostic procedure involving disc puncture with pressurization, is a test for presumptive discogenic pain in the lumbar. Lumbar highintensity zone and discography in subjects.
Much of the recent research into the limitations of discography as a diagnostic tool was done by dr. Eugene carragee, the director of stanfords orthopedic spine center, who has received four national prizes in recognition of his work. A prospective controlled study of patients without low back pain observed after experimental lumbar discography. 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. A range of morphologic and psychosocial variables has been suggested as risk factors for serious low back pain lbp illness. Carragee for the prosecution orthopedics this week. Don lumbar back pain is extremely common, but most cases are selflimiting with no functional deficit. Influence of intradiscal medication on nucleus pulposus. 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. One study was an assessment of patients who, like trisha bryant, underwent discography after having had some form of back surgery. Eugene carragee was the first to prove that provocative discography may contribute to intervertebral disc degeneration. Todd alamin, md, a farbod malek, md, a eugene carragee, md, a and mijung kim, md, phd b, author information article notes. 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.