Utjecaj provokacijske diskografije na kirurško liječenje bolesnika s kroničnom križoboljom Impact of provocative discography to surgical outcome in patients with chronic low back pain

摘要

The objective of the study was comparison of surgical outcomes of patients operated on without discography and patients that underwent discography. According to power analysis study comprised 310 patients divided in the experimental (No=207) and the control (No=103) group. Inclusion criteria were low back pain resistant to the nonsurgical treatment for more than 6 months and conventional radiological findings showing degenerative changes without clear generator of the pain. Exclusion criteria were red flags. Before discography patients filled in Oswestry Disability Index (ODI), SFPF36, Zung and MSPGQ Questioners. In a control group of patients with DDD difference between preoperative and postoperative ODI were 22.07% or 11 points. In a group with discography in patients with DDD difference between preoperative and postoperative ODI were 35.04% or 17.5 points. In a control group of patients with stenosis difference between preoperative and postoperative ODI were 26.13% or 13 points. In a group with discography in patients with stenosis difference between preoperative and postoperative ODI were 28.42% or 14.5 points. Provocative discography screening with psychological testing in the trial group made improvement following fusion clinically significant. For other degenerative generators of the pain discography didn’t prove useful diagnostic tool.