Lumbar Degenerative Disk Disease Differential Diagnoses

1. Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J. 2014 Nov 1. 14 (11):2525-45. [Medline]. [Full Text].

2. Donnally III CJ, Dulebohn SC. Lumbar Degenerative Disk Disease. 2018 Jan. [Medline]. [Full Text].

3. Kong MH, Hymanson HJ, Song KY, et al. Kinetic magnetic resonance imaging analysis of abnormal segmental motion of the functional spine unit. J Neurosurg Spine. 2009 Apr. 10(4):357-65. [Medline].

4. Kirkaldy-Willis WH. The pathology and pathogenesis of low back pain. In: Managing Low Back Pain. New York, NY:. Churchill Livingstone. 1988: 49.

5. Dean DD, Martel-Pelletier J, Pelletier JP, et al. Evidence for metalloproteinase and metalloproteinase inhibitor imbalance in human osteoarthritic cartilage. J Clin Invest. 1989 Aug. 84(2):678-85. [Medline].

6. Komiya Y. Immunohistochernical localization of tissue inhibitor of metalloproteinases (TIMP) and stromelysin in human joint synovium. Jpn J Rheum Joint Surg. 1992. 11:59-70.

7. MacNaul KL, Chartrain N, Lark M, et al. Discoordinate expression of stromelysin, collagenase, and tissue inhibitor of metalloproteinases-1 in rheumatoid human synovial fibroblasts. Synergistic effects of interleukin-1 and tumor necrosis factor-alpha on stromelysin expression. J Biol Chem. 1990 Oct 5. 265(28):17238-45. [Medline].

8. NCHS. National Center for Health Statistics. Prevalence of Selected Impairment. Hyattsville, MD:. US Department of Health and Human Services. 1984.

9. National Center for Health Statistics. Vital statistics of the United States. Washington, DC:. Government Printing Office. 1968-1988.

10. Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987 Apr. 12(3):264-8. [Medline].

11. Von Korff M, Deyo RA, Cherkin D, Barlow W. Back pain in primary care: outcomes at 1 year. Spine. 1993 Jun 1. 18(7):855-62. [Medline].

12. Frymoyer JW. Epidemiology: the magnitude of the problem. In: Wiesel SW, Weinstein JN, Herkowitz HH, Dvorak J, eds. The Lumbar Spine. 2nd ed. Philadelphia, PA: WB Saunders Co. 1996.

13. Luo X, Pietrobon R, Sun SX. Estimates and patterns of direct health care expenditures among individuals with back pain in the United States. Spine. 2004 Jan 1. 29(1):79-86.

14. Gautschi OP, Smoll NR, Corniola MV, et al. Sex differences in lumbar degenerative disc disease. Clin Neurol Neurosurg. 2016 Apr 8. 145:52-57. [Medline].

15. Bogduk N. Degenerative joint disease of the spine. Radiol Clin North Am. 2012 Jul. 50(4):613-28. [Medline].

16. Ayturk UM, Gadomski B, Schuldt D, Patel V, Puttlitz CM. Modeling degenerative disk disease in the lumbar spine: a combined experimental, constitutive, and computational approach. J Biomech Eng. 2012 Oct. 134(10):101003. [Medline].

17. Lee SU, Lee JI, Butts K, et al. Changes in posterior lumbar disk contour abnormality with flexion-extension movement in subjects with low back pain and degenerative disk disease. PM R. 2009 Jun. 1(6):541-6. [Medline].

18. D'Anastasi M, Birkenmaier C, Schmidt GP, Wegener B, Reiser MF, Baur-Melnyk A. Correlation between vacuum phenomenon on CT and fluid on MRI in degenerative disks. AJR Am J Roentgenol. 2011 Nov. 197(5):1182-9. [Medline].

19. Barrey C, Ene B, Louis-Tisserand G, Montana P, Perrin G, Simon E. Vascular Anatomy in the Lumbar Spine Investigated by Three-Dimensional Computed Tomography Angiography: The Concept of a Vascular Window. World Neurosurg. 2012 Apr 2. [Medline].

20. Panagiotacopulos ND, Pope MH, Krag MH, Block R. Water content in human intervertebral discs, I: Measurement by magnetic resonance imaging. Spine. 1987 Nov. 12(9):912-7. [Medline].

21. Watanabe A, Benneker LM, Boesch C, et al. Classification of intervertebral disk degeneration with axial T2 mapping. AJR Am J Roentgenol. 2007 Oct. 189(4):936-42. [Medline].

22. Smith BM, Hurwitz EL, Solsberg D, et al. Interobserver reliability of detecting lumbar intervertebral disc high- intensity zone on magnetic resonance imaging and association of high- intensity zone with pain and anular disruption. Spine. 1998 Oct 1. 23(19):2074-80. [Medline].

23. Aprill C, Bogduk N. High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging. Br J Radiol. 1992 May. 65(773):361-9. [Medline].

24. Schiebler ML, Grenier N, Fallon M, et al. Normal and degenerated intervertebral disk: in vivo and in vitro MR imaging with histopathologic correlation. AJR Am J Roentgenol. 1991 Jul. 157(1):93-7. [Medline].

25. Grenier N, Grossman RI, Schiebler ML, et al. Degenerative lumbar disk disease: pitfalls and usefulness of MR imaging in detection of vacuum phenomenon. Radiology. 1987 Sep. 164(3):861-5. [Medline].

26. de Roos A, Kressel H, Spritzer C, Dalinka M. MR imaging of marrow changes adjacent to end plates in degenerative lumbar disk disease. AJR Am J Roentgenol. 1987 Sep. 149(3):531-4. [Medline].

27. Modic MT, Steinberg PM, Ross JS, Carter JR. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 1988 Jan. 166(1 Pt 1):193-9. [Medline].

28. Quint U, Wilke HJ. Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings. Eur Spine J. 2008 Dec. 17(12):1705-13. [Medline].

29. Schellhas KP, Pollei SR, Gundry CR, Heithoff KB. Lumbar disc high-intensity zone. Correlation of magnetic resonance imaging and discography. Spine. 1996 Jan 1. 21(1):79-86. [Medline].

30. Son S, Lee SG, Kim WK, Ahn Y, Jung JM. Disc height discrepancy between supine and standing positions as a screening metric for discogenic back pain in patients with disc degeneration. Spine J. 2020 Jul 17. [Medline].

31. Walsh TR, Weinstein JN, Spratt KF, et al. Lumbar discography in normal subjects. A controlled, prospective study. J Bone Joint Surg [Am]. 1990 Aug. 72(7):1081-8. [Medline].

32. Scuderi GJ, Brusovanik GV, Golish SR, et al. A critical evaluation of discography in patients with lumbar intervertebral disc disease. Spine J. 2008 Jul-Aug. 8(4):624-9. [Medline].

33. Coppes MH, Marani E, Thomeer RT, Groen GJ. Innervation of "painful" lumbar discs. Spine. 1997 Oct 15. 22(20):2342-9; discussion 2349-50. [Medline].

34. Weinstein J, Claverie W, Gibson S. The pain of discography. Spine. 1988 Dec. 13(12):1344-8. [Medline].

35. Yoshihara H, Yoneoka D. National trends in the surgical treatment for lumbar degenerative disc disease: US, 2000-2009. Spine J. 2014 Oct 1. [Medline].

36. Freudenberger C, Lindley EM, Beard DW, et al. Posterior versus anterior lumbar interbody fusion with anterior tension band plating: retrospective analysis. Orthopedics. 2009 Jul. 32(7):[Medline].

37. Bozzio AE, Johnson CR, Fattor JA, et al. Stand-alone Anterior Lumbar Interbody, Transforaminal Lumbar Interbody, and Anterior/Posterior Fusion: Analysis of Fusion Outcomes and Costs. Orthopedics. 2018 Jul 16. 1-8. [Medline].

38. Robecchi A, Capra R. L'idrocortisone (composto F): prime esperienze cliniche in campo reumatologico. Minerva Med. 1952. 98:1259-63.

39. Swerdlow M, Sayle-Creer WS. A study of extradural medication in the relief of the lumbosciatic syndrome. Anaesthesia. 1970 Jul. 25(3):341-5. [Medline].

40. Winnie AP, Hartman JT, Meyers HL Jr, et al. Pain clinic, II: intradural and extradural corticosteroids for sciatica. Anesth Analg. 1972 Nov-Dec. 51(6):990-1003. [Medline].

41. Rosenberg SK, Grabinsky A, Kooser C, et al. Effectiveness of transforaminal epidural steroid injections in low back pain: a one year experience. Pain Physician. 2002 Jul. 5(3):266-70. [Medline].

42. Manchikanti L, Staats PS, Singh V, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2003 Jan. 6(1):3-81. [Medline].

43. Riew KD, Yin Y, Gilula L, et al. Can nerve root injections obviate the need for operative treatment of lumbar radicular pain? A prospective, randomized, controlled, double-blind study. Presented at the 14th Annual North American Spine Society Meeting. Chicago, IL, October 20-23, 1999.

44. Kraemer J, Ludwig J, Bickert U, et al. Lumbar epidural perineural injection: a new technique. Eur Spine J. 1997. 6(5):357-61. [Medline].

45. Karppinen J, Malmivaara A, Kurunlahti M, et al. Periradicular infiltration for sciatica: a randomized controlled trial. Spine. 2001 May 1. 26(9):1059-67. [Medline].

46. Thomas E, Cyteval C, Abiad L, et al. Efficacy of transforaminal versus interspinous corticosteroid injection in discal radiculalgia - a prospective, randomised, double-blind study. Clin Rheumatol. 2003 Oct. 22(4-5):299-304. [Medline].

47. Buttermann GR. Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study. J Bone Joint Surg Am. 2004 Apr. 86-A(4):670-9. [Medline].

48. Weiner BK, Fraser RD. Foraminal injection for lateral lumbar disc herniation. J Bone Joint Surg Br. 1997 Sep. 79(5):804-7. [Medline].

49. Lutz GE, Vad VB, Wisneski RJ. Fluoroscopic transforaminal lumbar epidural steroids: an outcome study. Arch Phys Med Rehabil. 1998 Nov. 79(11):1362-6. [Medline].

50. Wang JC, Lin E, Brodke DS, et al. Epidural injections for the treatment of symptomatic lumbar herniated discs. J Spinal Disord Tech. 2002 Aug. 15(4):269-72. [Medline].

51. Kapural L, Mekhail N. Novel intradiscal biacuplasty (IDB) for the treatment of lumbar discogenic pain. Pain Pract. 2007 Jun. 7(2):130-4. [Medline].

52. Kapural L, Ng A, Dalton J, et al. Intervertebral disc biacuplasty for the treatment of lumbar discogenic pain: results of a six-month follow-up. Pain Med. 2008 Jan-Feb. 9(1):60-7. [Medline].

53. Saal JS, Saal JA. A novel approach to painful internal disc derangement: collagen modulation with a thermal percutaneous navigable intradiscal catheter: a prospective trial. Proceedings of the 13th Annual Meeting of the North American Spine Society. 1998.

54. Freeman BJ, Fraser RD, Cain CM. A randomized, double-blind, controlled trial: intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain. Spine. 2005 Nov 1. 30(21):2369-77; discussion 2378. [Medline].

55. Derby R, Eek B, Ryan DP. Intradiscal electrothermal annuloplasty. Presented at 13th Annual Meeting North American Spine Society 13th Annual Meeting. San Francisco, CA, October 28-31, 1998.

56. Moon SH, Lee HM, Park MS. Bone morphogenic protein-2 facilitates expression of chondrogenic not osteogenic phenotype in human intervertebral disc cells. Program and abstracts of the 17th Annual Meeting of the North American Spine Soc. 2002.

57. Ahn N, Imai Y, An H. Effect of nutrient concentration and OP-1 on the metabolism of intervertebral disc: In vitro organ culture study. Program and abstracts of the 17th Annual Meeting of the North American Spine Soc. 2002.

58. Miyamoto K, Masuda K, Kim JG. Intradiscal injections of osteogenic protein-1 restore the viscoelastic properties of degenerated intervertebral discs. Spine J. 2006 Nov-Dec. 6(6):692-703.

Rajeev K Patel, MD Assistant Professor, Department of Orthopedics, University of Rochester; Consulting Surgeon, Strong Health Spine Center, Strong Memorial Health System

Rajeev K Patel, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, North American Spine Society

Disclosure: Nothing to disclose.

Curtis W Slipman, MD Director, University of Pennsylvania Spine Center; Associate Professor, Department of Physical Medicine and Rehabilitation, University of Pennsylvania Medical Center

Curtis W Slipman, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, International Association for the Study of Pain, North American Spine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Patrick M Foye, MD Director of Coccyx Pain Center, Professor of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School; Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, University Hospital

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans

Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

J Michael Wieting, DO, MEd, FAOCPMR, FAAOE Senior Associate Dean, Professor of Physical Medicine and Rehabilitation, Professor of Osteopathic Manipulative Medicine, Lincoln Memorial University-DeBusk College of Osteopathic Medicine

J Michael Wieting, DO, MEd, FAOCPMR, FAAOE is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Osteopathic Examiners, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Gold Humanism Honor Society, International Society for Communication Science and Medicine, Michigan Osteopathic Association, Oklahoma Osteopathic Association, Tennessee Osteopathic Medical Association

Disclosure: Nothing to disclose.

• Print this section
• Print the entire contents of
• Print the entire contents of article