As humans have evolved, science has developed, and living and working conditions have improved, people are suffering from more diseases, and the incidence of degenerative diseases of the lumbar spine has increased. disc degeneration is common in people over 50 years of age, and MRI cannot distinguish whether a lumbar disc with reduced signal on T2-weighting is a normal aging disc or a painful pathological disc. in 1986, Crock proposed the concept of internal rupture of the disc structure. In 1986, Crock introduced the concept of internal rupture of disc structures, suggesting that low back pain could occur without nerve root compression. Since then, the concept of discogenic pain is being accepted by more and more clinicians. What is meant by discogenic low back pain? Ross has two understandings of this: (1) it includes all low back pain caused by disc degeneration: intravertebral disc rupture, disc degeneration disease (DDD), disc herniation, intervertebral instability, etc.; (2) low back pain or radiating pain caused by the destruction of normal structures and biochemical changes inside the disc. I. Discogenic low back pain: It refers to chronic low back pain with or without lower limb radiating pain, starting from the intervertebral disc itself, caused by the destruction of the normal structure and biochemical changes inside the intervertebral disc or radiating pain. Under trauma and abnormal stress, it leads to rupture within the annulus fibrosus, which in turn causes degeneration of the nucleus pulposus, which may be normal in the early stages of IDD. II. Diagnosis of discogenic low back pain (a) Clinical symptoms:Most people have diffuse dull pain in the low back, with pain located in the lower back and buttocks, and some people may have associated lower chest, upper back, groin, and lower limb involvement pain. The symptoms of low back pain are aggravated by weight bearing. The sympathetic nerve traffic branch accompanying the sinus vertebral nerve makes it difficult to localize the pain. (B) Lumbar discography: This is the only method to diagnose discogenic low back pain. CT examination is performed immediately after the imaging to further improve the diagnostic rate. Excitation pain experiment 1. Clinical classification (patient feeling): (1) no pain without pressure sensation; (2) pressure sensation without pain; (3) inconsistent pain; (4) similar pain; (5) completely consistent pain. 2. Problems with stimulated pain experiments: chronic pain appears to be centrally sensitized, and the activity of the dorsal horn of the spinal cord no longer relies on physiological stimulation of peripheral tissue injury to cause pain; psychological factors (subjective feelings). Fourth, the diagnostic value of MRI for discogenic low back pain MRI can observe the morphology and culmination of the intervertebral disc. t2 like high signal zone in the posterior part of the fibrous ring (HIZ), an MRI sign, is present in 37% of patients with low back pain. the essence of HIZ is the inflammatory reaction of the posterior outer fibrous ring; the protrusion of nucleus pulposus material into the outer fibrous ring via the rupture tract; the vascularization of the outer fibrous ring. according to Carragee The diagnostic value of HIZ is not significant, as the rate of HIZ is 59% for those with back pain and 24% for those without back pain. In our recent study, we found that the higher the grade of fibrous ring rupture, the higher the percentage of HIZ on MRI, and the degree of fibrous ring rupture with high signal areas was severe (P<0.01). There was no significant agreement between the high signal area and positive contrast pain response (P>0.05). MRI findings need to be closely integrated with discography to play an important role in the selection of surgical segments.