Internal disc disruption: Difference between revisions

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== Clinically Relevant Anatomy  ==
== Clinically Relevant Anatomy  ==


Click on the link for more specific details about intervertebral disc.
Click on the link for more specific details about [http://www.physio-pedia.com/index.php/Intervertebral_disc intervertebral disc].


== Epidemiology /Etiology  ==
== Epidemiology /Etiology  ==

Revision as of 15:33, 21 December 2011

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors

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Search Strategy[edit | edit source]

PubMed:
• Internal disc disruption
Web of knowledge:
• Internal disc disruption
No language restrictions were made, but only English articles have been used.
Google Books:
• Internal disc disruption

Definition/Description[edit | edit source]

It is assumed that Internal Disc Disruption (IDD) is an important cause of low back pain[1]. Crock[2] defined that the affected disc in IDD is rendered painful by changes in its internal structure, while its external appearance remains  normal. In particular he reported annular fissures that distort the internal architecture of the disc while the disc externally appears intact and undeformed. This forms the major difference between IDD and disc herniation, which shows a true disruption of the external structure. IDD is not the same as disc degeneration. It’s a condition in which you can speak of a degeneration of the matrix of the nucleus pulposus with radial fissures that penetrate the annulus fibrosus but do not reach the outer lamella[3]
IDD of the lumbar intervertebral disc is often overlooked as possible diagnosis in chronic low back pain[4].

Clinically Relevant Anatomy[edit | edit source]

Click on the link for more specific details about intervertebral disc.

Epidemiology /Etiology[edit | edit source]

Chronic low back pain is the major cause of work-related disability in people under age 45. Only a few of these patients (< 15%) has a discus herniation, which compromise a nerve-root. The majority of this population (85%) suffers from non-neurological back pain and a significant proportion of these patients are assumed to be related to musculoligamentous injury or degenerative changes. Internal disc disruption is a common entity.

30% to 50% of people with chronic low back pain become an IDD diagnosis. In principle, any structure in the spine can be a possible source of pain because it is innervated (rich innervation of the outer third of the annulus fibrosus, extended nerve fibers in the middle third of the annulusi) .

Characteristics/Clinical Presentation[edit | edit source]

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Differential Diagnosis[edit | edit source]

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Diagnostic Procedures[edit | edit source]

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Examination[edit | edit source]

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Physical Therapy Management
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Key Research[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. Schwarzer A.C., Aprill C.N., Derby R. et al. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine 1195;20:1878-1883. Level of evidence: B
  2. Crock H.V. Internal disc disruption. A challenge to disc prolapse fifty years on. Spine 1986; 22:650-3 Level of evidence: C
  3. DePalma M.J. iSpine – Evidence-Based Interventional Spine Care. New York: Demos Medical Publishing: 2011. Level of evidence: D
  4. Sehgal N., Fortin J.D. Internal Disc Disruption and Low Back Pain. Pain Physician 2000; 2(3): 1143-157. Level of evidence: A2