[Contrast medium turnover in discography (author's transl)]

Area of Science:

• Radiology
• Orthopedics
• Neurosurgery

Background:

• Discography's diagnostic role has diminished with advanced imaging like Metrizamide myelo- and radiculography.
• However, it retains value for pre-operative assessment in specific cases of lumbo-sciatic and cervico-brachial pain.

Purpose of the Study:

• To re-evaluate the utility of discography, focusing on contrast medium turnover in the vertebral interspace.
• To assess the diagnostic accuracy of contrast medium clearance rates in identifying discopathy.

Main Methods:

• Contrast medium turnover was evaluated using serial X-ray views at 12, 24, and 48 hours post-discography.
• In select cases, turnover was further analyzed by assessing the half-life curve of co-injected Technetium radioactive isotope.
• Morphological disturbances and contrast clearance were correlated with surgical outcomes.

Main Results:

• In normal lumbar discs, contrast medium remained visible at 24 hours post-injection.
• In cases of discopathy, the contrast medium disappeared completely by 24 hours, a finding corroborated by isotope turnover.
• Similar, though slightly shorter, delays were observed in cervical discs.

Conclusions:

• Contrast medium turnover is a reliable radiological sign for diagnosing discopathy, particularly in pre-operative evaluations.
• This method remains valuable for a majority of operated discopathies, complementing morphological findings.
• Discography, when assessing contrast clearance, continues to be a relevant diagnostic tool for specific spinal conditions.