BackTable / MSK / Podcast / Episode #67
Introduction to Treatment of Discogenic Back Pain
with Dr. Olivier Clerk-Lamalice
Degenerative disc disease, a major cause of low back pain, is the most common musculoskeletal issue worldwide, affecting an estimated 15-30% of the population. In this episode of BackTable MSK, interventional radiologists Dr. Olivier Clerk-Lamalice and Dr. Jacob Fleming cover symptomatic degenerative disc disease, focusing on its diagnosis and treatment with anesthetic injections. This is the first episode in a two-part series on discogenic back pain.
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BackTable, LLC (Producer). (2025, February 4). Ep. 67 – Introduction to Treatment of Discogenic Back Pain [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Olivier Clerk-Lamalice
Dr. Olivier Clerk-Lamalice is an interventional radiologist that specializes in interventional pain management and diagnostic imaging in Calgary, Canada.
Dr. Jacob Fleming
Dr. Jacob Fleming is a diagnostic radiology resident and future MSK interventional radiologist in Dallas, Texas.
Synopsis
Dr. Clerk-Lamalice begins by explaining the pathophysiology of disc degeneration, which can lead to painful annular tears and loss of disc height. The doctors also reflect on the history of discography, from provocative discograms to the more recent anesthetic and CT discograms. They review the modified Dallas Discogram Classification for annular tears, the vacuum disc phenomenon, and the importance of dynamic imaging to assess treatment candidacy. Dr. Clerk-Lamalice emphasizes the need to correlate imaging with physical examination to better identify the symptomatic disc level.
The episode also discusses the challenges of managing multi-level disc degeneration and underscores the importance of early-stage intervention.
Timestamps
00:00 - Introduction
02:44 - Pathophysiology of Disc Degeneration
06:49 - Evolution of Discography
12:55 - Classification of Annular Tears
09:01 - Diagnostic Tools and Techniques
14:00 - CT Discogram and Annular Tear Classification
17:12 - Dynamic Aspects and Instability
22:20 - Identifying Symptomatic Disc Level
28:25 - Treatment Approaches and Patient Selection
Resources
Get $100 off of your GRIBOI Conference registration using this link:
www.eventbrite.com/e/1027273521757/?discount=BackDoorGRIBOIPromoCode
Visit the GRIBOI website for special hotel rates, available until March 11, 2025:
https://www.griboi.org/annualconference
BackTable MSK Ep. 13- Basivertebral Nerve Ablation with Dr. Olivier Clerk-Lamalice:
https://www.backtable.com/shows/msk/podcasts/13/basivertebral-nerve-ablation
Modified Dallas Discogram Classification System:
https://pubmed.ncbi.nlm.nih.gov/2954226/
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.