Pathophysiology, diagnosis, and management of discogenic low back pain: a phenotype-driven precision framework for surgical and interventional decision-making - Summary - MDSpire

Pathophysiology, diagnosis, and management of discogenic low back pain: a phenotype-driven precision framework for surgical and interventional decision-making

  • By

  • Yanxu Feng

  • Yahao Li

  • Zhongqiu Sa

  • Zhilin Bai

  • Feng Mao

  • Jiangfeng Yu

  • May 25, 2026

  • 0 min

Share

Objective:

To evaluate the pathophysiology and phenotype-based management of Discogenic Low Back Pain (DLBP).

Key Findings:
  • DLBP can be stratified into four clinical phenotypes: vertebrogenic, annulogenic, mixed, and neuro-sensitized.
  • Vertebrogenic DLBP is associated with endplate inflammation and Modic changes.
  • Annulogenic DLBP involves annular fissures.
  • Mixed DLBP may require combined denervation strategies.
  • Neuro-sensitized DLBP may involve central and peripheral sensitization.
  • Functional myofascial or fascial involvement can be assessed clinically and with ultrasound.
Interpretation:

Limitations:
  • The review is based on existing literature and may not encompass all recent developments post-April 2026.
  • The heterogeneity of DLBP and its overlapping clinical presentations complicate definitive diagnosis and treatment.
Conclusion:

A structured framework for DLBP management is discussed, focusing on individualized treatment selection.

Original Source(s)

Pathophysiology, diagnosis, and management of discogenic low back pain: a phenotype-driven precision framework for surgical and interventional decision-making

  • by Yanxu Feng, Yahao Li, Zhongqiu Sa, Zhilin Bai, Feng Mao, Jiangfeng Yu

  • May 25, 2026

Related Content

Anterior Lumbar Interbody Fusion (ALIF): A Collaborative Approach to Spine Surgery

In this procedural case review, vascular surgeon Dr. Samuel Steerman and neurosurgeon Dr. Shannon Clark collaborate to perform an anterior lumbar interbody fusion (ALIF).

  • May 29, 2026

  • 1 min
Preoperative oral spicy stimulation for postoperative pain reduction after spinal surgery: a randomized controlled trial

Correction: Comparison of in vitro and in vivo toxicity of bupivacaine in musculoskeletal applications