Internal Disc Disruption

What is internal disc disruption?

Internal disc disruption or discogenic pain syndrome is an entity affecting the intervertebral disc. It is caused by fissures in the ring of the disc that distort the internal architecture of the disc, making it structurally incompetent and a source of pain. Patients with internal disc disruption classically complain of low back pain and may have a radiating component with radicular or nerve root type of pain. Unlike disc herniations, this pain is not the result of disc compression affecting the exiting nerve root.

What are some symptoms of internal disc disruption?

The pain caused by internal disc disruption or discogenic pain syndrome is usually one of long-standing and chronic duration. The pain is exacerbated with activities that increase intradiscal pressure. Such activities include sitting, lifting and bending.

How is internal disc disruption diagnosed?

The diagnosis of internal disc disruption is often elusive and can overlap with many other conditions affecting the spine. Therefore, one has to rely on diagnostic testing to arrive at and confirm the diagnosis. A MRI is usually obtained but is non-specific for the diagnosis of internal disc disruption. The gold standard of diagnosis is provocative discography. This test when done properly may show both the structural abnormality of the disc and may demonstrate reproduction of similar pain that is the hallmark of this disorder.

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