Imaging of the Postoperative Spine: Discectomy and Herniectomy

Abstract

Low-back pain (LBP) is a frequent complaint and a leading cause of disability in the general population. Epidemiological studies have identifi ed many indi- vidual, psychosocial, and occupational risk factors for its onset, but the primary causative mechanisms of LBP remain largely undetermined. Psychological factors have an important role in the transition from acute to chronic pain and related disability (Manek and MacGregor 2005). Recent advances show that there is also a signifi cant genetic effect on severe LBP, a condition which is responsible for a substantial loss in productivity. The total costs of LBP in the US ex- ceed $100 billion per year (Katz 2006). Two-thirds of these costs are indirect, due to lost wages and reduced productivity. Each year, the less than 5% of the pa- tients who have an episode of LBP account for 75% of the total costs (Jinkins 1997). Most episodes of LBP have a mechanical origin and are self-limiting, resolving within a few days or weeks (Borenstein 1996). There is considerable scope for prevention of the consequences of LBP such as recurrence, disabil- ity, and workloss. Different interventions and out- comes will be appropriate for different target popula- tions, yet inevitably there is an overlap.