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Related Experiment Videos

Lumbar discography: current concepts and controversies.

Philip H Lander1

  • 1Department of Diagnostic Radiology, University of Alabama at Birmingham, Jefferson Tower, Suite N316, 619 19th Street South, Birmingham, AL 35243, USA.

Seminars in Ultrasound, CT, and MR
|April 29, 2005
PubMed
Summary
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Lumbar provocation discography identifies pain from within lumbar discs by imaging radial fissures after contrast injection. Concordant pain reproduction and annular tears indicate internal disc disruption, distinct from degeneration.

Area of Science:

  • Orthopedics
  • Radiology
  • Pain Management

Background:

  • Lumbar discography is an invasive diagnostic tool.
  • Identifies pain originating from within lumbar discs.
  • Radial fissures within discs can be imaged via contrast injection.

Purpose of the Study:

  • To review the validity and technique of lumbar discography.
  • To present recently described causes of false-positive responses.
  • To differentiate internal disc disruption from disc degeneration.

Main Methods:

  • Injection of radiopaque contrast into the nucleus pulposus.
  • Controlled reproduction of concordant low back and/or referred somatic pain.
  • Demonstration of annular radial tears.

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Main Results:

  • Internal disc disruption is characterized by radial fissures and concordant pain reproduction.
  • This condition is distinct from degenerative disc disease.
  • False-positive responses can occur and are discussed.

Conclusions:

  • Lumbar provocation discography is a key diagnostic method for internal disc disruption.
  • Accurate interpretation requires understanding potential false-positive findings.
  • The procedure helps differentiate specific disc pathologies.