Lumbar provocative discography
Lumbar provocative discography | |
---|---|
Lumbar provocative discography (also referred to as "discography" or discogram) is an invasive diagnostic procedure for evaluation for intervertebral disc pathology. It is usually reserved for persons with persistent, severe low back pain (LBP) who have abnormal spaces between vertebrae on magnetic resonance imaging (MRI), where other diagnostic tests have failed to reveal clear confirmation of a suspected disc as the source of pain, and surgical intervention is being considered.
Uses
Spinal MRI is the imaging of choice to investigate the spine and intervertebral discs.
For those with local or distant sepsis, lumbar discography can add to the risk of infective discitis. Those with co-morbities that caused them not to be suitable candidate for surgery is also relatively contraindicated for this procedure.[1]
Procedure
Non-ionic contrast media such as iopamidol and iohexol are used.[1] Needles are inserted through the back into the
This is repeated in random order for the various discs, without the patient knowing which disc is pressurized. This can be used to detect patients who may be exaggerating their symptoms, or to assess their pain response and hence their suitability for recovery from possible surgery (often a Discectomy).
A
Possible complications include nerve damage,
Its use in predicting surgical outcomes is sometimes controversial.
History
Lindgren from Scandinavia first performed a puncture of normal intervertebral disc for diagnostic purposes in 1941.[3]
References
- ^ ISBN 9780702071669.
- ^ "Discography". Archived from the original on 30 May 2022. Retrieved 30 May 2022.
- ^ Tomecek, FJ; Anthony, CS; Boxell, C; Warren, J. "Discography Interpretation and Techniques in the Lumbar Spine". Medscape. Archived from the original on 3 April 2017. Retrieved 30 May 2022.