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Provocation discography as a guide to planning operations on the spine
E Colhoun1, I W McCall, L Williams
1Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, England.
The Journal of Bone and Joint Surgery. British Volume
|March 1, 1988
Summary
Lumbar discography helps identify patients with low back pain who will benefit from surgery. When discography provokes symptoms, 89% experience sustained relief after surgery.
Area of Science:
- Orthopedics
- Neurosurgery
- Pain Management
Background:
- Low back pain is a common condition often requiring surgical intervention.
- Accurate diagnostic tools are crucial for selecting appropriate surgical candidates.
- Lumbar discography's role in evaluating patients with specific pain patterns requires definition.
Purpose of the Study:
- To define the diagnostic utility of lumbar discography.
- To assess its effectiveness in patients with low back pain and non-dermatomal leg pain.
- To correlate discographic findings with surgical outcomes.
Main Methods:
- Prospective study of 195 patients undergoing lumbar surgery.
- Analysis of patient records at least two years post-operation.
- Evaluation of lumbar discography findings (disc disease, symptom provocation) and surgical success.
Main Results:
- 89% of patients with positive discography (disc disease and provoked symptoms) had significant, sustained clinical benefit from surgery.
- Only 52% of patients with disc abnormalities but no symptom provocation on discography achieved clinical success.
- Lumbar discography demonstrating symptom provocation is a strong predictor of surgical success.
Conclusions:
- Lumbar discography is a valuable tool for investigating patients with low back pain.
- Positive symptom provocation during discography indicates a higher likelihood of surgical success.
- The procedure aids in selecting patients who will benefit from surgical intervention for low back pain.