The role of provocative discography in surgical treatment for patients with chronic low back pain

INTERVENTION: At first all 310 patients were randomized into a trial group with 207 patients and a control group with 103 patients. Patients in trial group filled in the Oswestry, Zung and MSPQ test, if the results did not show high depression values (Zung results more than 33) and somatisation (MSPQ results more than 12 in patients with Zung results between 18 and 33) we considered the patients adequate to be sent to provocative discography. Patients with positive findings on provocative discography were sent to surgical treatment. Surgery was performed on patients in trial group with positive finding on discography and also on all patients in control group without discography. All patients, in both groups were categorized by Thalgott. In cases categorized as C and/or D changes on more segments (mostly two) we performed transpedicular fixation. In cases categorized E and F group by Thalgott we performed circumferential ? posterolateral and intercorporal fixation. CONDITION: Low back pain/ischiatic pain ; Musculoskeletal Diseases ; Low back pain PRIMARY OUTCOME: 1. Statistically significant difference between two pre‐operative groups should be 4 points or 8%; 2. Statistically significant difference between pre‐operative and post‐operative groups should be 10 points or 20% SECONDARY OUTCOME: 1. 36‐item Short Form Health Survey (SF‐36) update; 2. Likert bipolar scaling method measuring either positive or negative response to a statement INCLUSION CRITERIA: 1. Aged 23 ‐ 74 years, either sex 2. Chronic low back pain and ischiatic pain 3. Radiological findings describe more than one cause of the pain 4. Uncertain clinical status after complete diagnostic imaging