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Related Experiment Video

Updated: May 8, 2026

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

Published on: August 7, 2018

Provocative discography screening improves surgical outcome.

Petra Margetic¹, Roman Pavic, Marin F Stancic

¹Department of Radiology, Clinic for Traumatology, University Hospital Sisters of Mercy, Draskoviceva 19, 10000, Zagreb, Croatia, hpetra23@gmail.com.

Wiener Klinische Wochenschrift

|August 31, 2013

Summary

Surgical fusion for degenerative disc disease (DDD) showed greater improvement with preoperative discography. This diagnostic tool, combined with psychological screening, led to clinically significant outcomes in patients undergoing spinal fusion.

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Area of Science:

Spine surgery
Diagnostic imaging
Pain management

Background:

Low back pain resistant to conservative treatment is common.
Conventional imaging often shows degenerative changes without a clear pain generator.
Preoperative diagnostic accuracy is crucial for successful surgical outcomes.

Purpose of the Study:

To compare surgical outcomes in patients with and without preoperative discography.
To evaluate the impact of discography on patient-reported outcomes after spinal surgery.

Main Methods:

Randomized controlled trial with 310 patients (207 trial, 103 control).
Inclusion: chronic low back pain, radiological degenerative changes. Exclusion: red flags.
Standard imaging followed by Oswestry Disability Index (ODI) and SF-36 questionnaires; trial group had discography and psychological testing.

Related Experiment Videos

Last Updated: May 8, 2026

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

Published on: August 7, 2018

Main Results:

The trial group (with discography) showed a 35.04% improvement in ODI for DDD subgroup, compared to 22.07% in the control group.
For other indications, the trial group improved ODI by 28.42% versus 26.13% in the control group.
Improvements in the control group did not reach the 15 ODI point clinical significance threshold.

Conclusions:

Surgical fusion for degenerative disc disease without discography did not achieve clinically significant improvement.
Provocative discography screening, alongside psychological testing, significantly enhanced outcomes following spinal fusion surgery.