Lumbar discoblock and intervertebral disc-related degenerative features. Interjacent association and prognostic value on lumbar spine surgery outcomes.
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Auditorium 7 of Oulu University Hospital
Topic of the dissertation
Lumbar discoblock and intervertebral disc-related degenerative features. Interjacent association and prognostic value on lumbar spine surgery outcomes.
Doctoral candidate
Licentiate of Medicine Tero Korhonen
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Health Sciences and Technology
Subject of study
Medicine
Opponent
Professor Juhana Hakumäki, University of Eastern Finland
Custos
Docent Jaakko Niinimäki, University of Oulu
Lumbar discoblock and intervertebral disc-related degenerative features. Interjacent association and prognostic value on lumbar spine surgery outcomes.
Low back pain (LBP) presents a significant global health burden. Despite approximately 30–40% of chronic LBP being presumed to originate from the intervertebral disc (IVD), diagnosing painful IVD may be clinically challenging, especially noninvasively. Within invasive diagnostic methods for IVD-related LBP, discoblock is a relatively novel and less studied method. Of the magnetic resonance imaging (MRI) findings in the context of LBP, attention has focused on vertebral bone marrow (BM) alterations referred to as Modic changes (MC, types I-III [MC1 3]), which have been proposed to associate with a specific subtype of LBP.
Study I retrospectively investigated the preoperative prognostic value of discoblock on short-term disability outcomes following lumbar fusion or total disc replacement (TDR) surgery. The correlation between the degree of pain relief following discoblock (ΔNRSDB) and favorable short-term disability outcome was very strong and significant in the fusion subgroup. The results indicate that discoblock is a viable tool in preoperative patient selection for lumbar fusion surgery and warrants further validation studies.
Study II examined the association between ΔNRSDB and the presence and type of MC. The study setting was retrospective and shared the same study population with Study I. Patients with any MC or MC1 in the lumbar segment in question exhibited significantly higher ΔNRSDB values compared to those without MC. Based on the results, MC1 are associated with LBP, and the pain originates at least partly from the IVD or the adjacent endplate.
In Study III, a novel MRI-based criterion for preoperative co-occurring advanced-level IVD-related degenerative phenotypes was developed and evaluated for its efficacy in predicting short-term outcomes following lumbar single-level discectomy within a retrospective patient cohort. Meeting this criterion, termed Advanced Preoperative Degeneration (APD), was significantly correlated with worse outcomes in leg pain and disability one year postoperatively.
Study I retrospectively investigated the preoperative prognostic value of discoblock on short-term disability outcomes following lumbar fusion or total disc replacement (TDR) surgery. The correlation between the degree of pain relief following discoblock (ΔNRSDB) and favorable short-term disability outcome was very strong and significant in the fusion subgroup. The results indicate that discoblock is a viable tool in preoperative patient selection for lumbar fusion surgery and warrants further validation studies.
Study II examined the association between ΔNRSDB and the presence and type of MC. The study setting was retrospective and shared the same study population with Study I. Patients with any MC or MC1 in the lumbar segment in question exhibited significantly higher ΔNRSDB values compared to those without MC. Based on the results, MC1 are associated with LBP, and the pain originates at least partly from the IVD or the adjacent endplate.
In Study III, a novel MRI-based criterion for preoperative co-occurring advanced-level IVD-related degenerative phenotypes was developed and evaluated for its efficacy in predicting short-term outcomes following lumbar single-level discectomy within a retrospective patient cohort. Meeting this criterion, termed Advanced Preoperative Degeneration (APD), was significantly correlated with worse outcomes in leg pain and disability one year postoperatively.
Last updated: 19.3.2025