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Discogenic low back pain
Spondylolisthesis: flexion/extension views
From the collection of Dr N. Quiraishi
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Discogenic low back pain
Pre- and post-surgical views: a patient presents with back pain and neurogenic claudication with stenosis and degenerative slip at L4-5 and a degenerate disc at L5S1 (left, T2-weighted sagittal MRI); L4-S1 decompression and instrumented fusion and a 2-level transforaminal lumbar interbody fusion was performed (AP radiograph top; lateral, bottom)
From the collection of Dr N. Quiraishi
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Discogenic low back pain
MRI spine: degenerate L4-5 disc with a disc bulge and L5S1 disc with a high-intensity zone
From the collection of Dr N. Quiraishi
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Discogenic low back pain
Postoperative radiographs
From the collection of Dr N. Quiraishi
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Discogenic low back pain
Discography: a patient presents with back and right leg pain that did not respond to a trial of conservative management. MRI (left, sagittal T2-weighted image) demonstrates multiple degenerate discs with loss of normal hydration, reduced signal, and loss of the nuclear-annular transition, with a normal disc height. A 3-level discography at L3-4, L4-5, and L5S1 (middle, AP radiograph; right, lateral radiograph) reveals a low-pressure injection with degenerate annular tears at all 3 levels, with 5/5 pain concordance at L5S1; 3/5 at L4-5; and 0/5 at L3-4
From the collection of Dr N. Quiraishi
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Discogenic low back pain
Preoperative MRI sagittal T2 sequence
From the collection of Dr N. Quiraishi
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Discogenic low back pain
Intra-operative images showing a gradual reduction of the deformity: L4 to S1 instrumented fusion, transforaminal fusion at L5S1 and bilateral L5 decompression
From the collection of Dr N. Quiraishi
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Discogenic low back pain
T2-weighted MRI spine: sagittal view (left) demonstrates degenerate discs; axial view (right) demonstrates left-sided L5S1 foraminal narrowing
From the collection of Dr N. Quiraishi
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Discogenic low back pain
MRI spine: degenerate facet joints and a large facet cyst from the left L5S1 facet joint compressing the left S1 nerve root
From the collection of Dr N. Quiraishi
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Discogenic low back pain
T2-weighted MRI spine: sagittal view (left) demonstrates 2 level disc dehydration at L4-5 and L5S1 with a moderate reduction in disc height; axial views (right) demonstrate constitutionally narrow canal at L4-5 with a moderate disc prolapse and a large disc prolapse at L5S1 level with left S1 root compression
From the collection of Dr N. Quiraishi
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Discogenic low back pain
Disc replacement: patient presents with severe back pain, having previously undergone right L5S1 discectomy for a right S1 radiculopathy. Though initially recovered, the right S1 pain recurred after 10 months, with back pain. An MRI scan shows a degenerate L5S1 disc (left, T2-weighted sagittal view). Patient subsequently had a disc replacement (AP radiograph top right, lateral bottom right). The pain in the back and the right leg resolved completely
From the collection of Dr N. Quiraishi
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