Black Disk Disease: Management and Assessment of Evidences

Introduction & In this manuscript, it is not intended to discuss the real indications or different techniques in the management of lumbar disc disease, but it is intended to put forward the question; “Is disc degeneration a disease?”. Accordingly, it will be tried to review the literature in a narrative manner and give way to the readers to design better studies for finding the real answer. A Medline search was done by following the key words: Black disc, Lumbar Disc herniation, Low back pain. The criteria for inclusion were relevance to the topic, randomized clinical trial, natural course or cohort study. 8 randomized trials, one cohort and one natural course studies were selected. As we shall see, the present studies have not found a suitable answer to this question. Furthermore, weak and divertive studies are not rare in this case.