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Registered Bioimaging of Nanomaterials for Diagnostic and Therapeutic Monitoring
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Diagnostic and therapeutic spinal interventions: Diskography.

Timothy P Maus1, J D Bartleson1

  • 1Departments of Radiology (TPM) and Neurology (JDB), Mayo Clinic, Rochester, MN.

Neurology. Clinical Practice
|February 24, 2018
PubMed
Summary

Diskography is an invasive diagnostic test to identify internal disc disruption as a cause of axial spine pain. While useful for diagnosing discogenic pain, its role in guiding treatment is limited by a lack of validated therapies.

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Area of Science:

  • Spine diagnostics
  • Pain management
  • Interventional radiology

Background:

  • Axial spine pain is often challenging to diagnose.
  • Internal disc disruption is a potential cause of axial spine pain.
  • Accurate diagnosis is crucial to avoid inappropriate interventions.

Purpose of the Study:

  • To evaluate the diagnostic utility of diskography for axial spine pain.
  • To assess the role of diskography in confirming or excluding internal disc disruption.
  • To review the limitations and risks associated with diskography.

Main Methods:

  • Diskography involves injecting fluid into the nucleus of the intervertebral disc under manometric control.
  • A positive response is defined as reproduction of the patient's typical pain.
  • Literature review to assess evidence supporting diskography in different spinal regions (lumbar, cervical, thoracic).

Main Results:

  • Diskography is validated in the lumbar spine, with less support in the cervical or thoracic spine.
  • Positive diskography can confirm discogenic pain and prevent interventions targeting other pain generators.
  • Negative diskography can help exclude discogenic pain, preventing unnecessary disc-directed treatments.

Conclusions:

  • Diskography is a valuable tool for diagnosing discogenic pain.
  • The procedure has limitations, including risks of infection, neural injury, and potential accelerated disc degeneration.
  • Its utility in patient selection for specific therapies is currently limited due to the lack of validated treatment options.