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- This is known as hard or “dark” disc disease
- There is degeneration of lumbar disc, leading to back pain without evidence of neural compression
- X-rays show disc space narrowing. MRI shows degenerate discs (i.e. ↓ signal on T2 weighted images)
- If there is no response to NSAIDs, conditioning & activity modification discograms can be performed
- degenerate levels, plus one or two normal levels, are injected
- Injection of degenerate discs should provoke pain; injection of normal discs should be painless
- In presence of such findings & ongoing pain it is possible to perform interbody fusion
