RESULTS The results of this review confirm and help quantify the significant differences that existed in the terminology and all the areas of diagnosis and treatment of presumed discogenic pain .
Our findings show that suspected discogenic pain , despite its extensive affirmation in the literature and enormous re sources regularly devoted to it , currently lacks clear diagnostic criteria and uniform treatment or terminology
BACKGROUND CONTEXT Pain innate to intervertebral disc , often referred to as discogenic pain , is suspected by some authors to be the major source of chronic low back and neck pain .
Current management of suspected discogenic pain lacks st and ardized diagnosis , treatment , and terminology .
PURPOSE In an attempt to determine whether patterns existed that may facilitate st and ardization of care , we sought to analyze the terminologies used and the various modes of diagnosis and treatment of suspected discogenic pain .
A Prospective, Randomized Controlled Clinical Trial of Anterior Lumbar Interbody Fusion Using a Titanium Cylindrical Threaded Fusion Device
Study Design . A prospect i ve , r and omized , controlled clinical trial comparing a cylindrical threaded titanium cage to a femoral ring allograft control for anterior lumbar interbody fusion . Objective . To compare these two implants with regard to arthrodesis . Secondary outcome measures included pain relief , neurological status , and general health status . Summary of Background Data . Anterior lumbar interbody fusion is a well-accepted procedure using trapezoidal femoral ring allografts or cylindrical titanium cages . Clinical and biomechanical studies evaluating these two distinct constructs are numerous ; however , no prospect i ve , r and omized study comparing them has been done . Methods . A multicenter trial of 140 patients : 78 were r and omized to the cylindrical threaded titanium cage device treatment arm and 62 patients r and omized into the control group . All had autogenous iliac crest bone graft  packed into the device . All patients had a single-level st and -alone anterior lumbar interbody fusion at either the L4–L5 or L5–S1 interspace for symptomatic degenerative disc disease . Radiographic fusion data were collected as well as multiple types of outcome data , including pain/disability scores , neurologic status , and overall health . Results . At 12 months , 97 % of the cylindrical threaded titanium cage device group and 40 % of the control group demonstrated radiographic fusion . At 24 months , 97 % of the cylindrical threaded titanium cage group and 52 % of the control group showed radiographic fusion . These fusion rate differences are statistically significant ( P < 0.001 ) . The Oswestry and neurologic scores were not significantly different between groups . Discussion . This is the first prospect i ve , r and omized , multicenter clinical trial that compares fusion cage results to control data . Conclusion . Cylindrical threaded titanium cages have a higher fusion rate , comparable improvements in clinical outcome ( Oswestry , Low Back Pain Question naire , SF-36 ) , and fewer secondary supplemental fixation procedures compared to the femoral ring allograft control
RESULTS The results of this review confirm and help quantify the significant differences that existed in the terminology and all the areas of diagnosis and treatment of presumed discogenic pain .
Our findings show that suspected discogenic pain , despite its extensive affirmation in the literature and enormous re sources regularly devoted to it , currently lacks clear diagnostic criteria and uniform treatment or terminology
BACKGROUND CONTEXT Pain innate to intervertebral disc , often referred to as discogenic pain , is suspected by some authors to be the major source of chronic low back and neck pain .
Current management of suspected discogenic pain lacks st and ardized diagnosis , treatment , and terminology .
PURPOSE In an attempt to determine whether patterns existed that may facilitate st and ardization of care , we sought to analyze the terminologies used and the various modes of diagnosis and treatment of suspected discogenic pain .