Diagnostic discography: what is the clinical utility?

Area of Science:

• Spine surgery
• Pain management
• Diagnostic imaging

Background:

• Discogenic back pain diagnosis and treatment remain challenging.
• Provocation discography is an invasive diagnostic procedure for internal disc disruption.
• Its utility is debated, with concerns about validity and false-positive rates.

Purpose of the Study:

• To provide an updated review on the safety and utility of provocation discography.
• To cover key areas of debate including false-positive rates, technical parameters, and clinical utility.
• To discuss the risk of procedural-related intervertebral disc damage.

Main Methods:

• Review of scientific literature on provocation discography.
• Analysis of technical refinements and their impact on limitations.
• Evaluation of clinical utility and safety data.

Main Results:

• Technical refinements have addressed initial limitations of provocation discography.
• Ongoing debate exists regarding false-positive rates and clinical utility.
• The risk of disc damage is a consideration in its application.

Conclusions:

• Provocation discography, despite historical challenges, offers valuable diagnostic information for discogenic pain.
• Technical advancements have improved its reliability and safety profile.
• Careful patient selection and procedural technique are crucial for optimal outcomes.