Evaluation of cervical diskography in pain origin and provocation

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• Cervical spondylotic myelopathy is a common condition.
• Accurate diagnosis of symptomatic cervical discs is crucial for effective treatment.
• Cervical diskography is a diagnostic tool used to identify pain generators in the cervical spine.

Purpose of the Study:

• To evaluate the diagnostic accuracy of cervical diskography in reproducing neck pain.
• To determine the reliability of provocative pain during cervical diskography.

Main Methods:

• A study of 144 patients with cervical spondylotic myelopathy, radiculopathy, or amyotrophy.
• Cervical diskography was performed using a nonionic contrast medium (Iohexol).
• Patients were divided into a symptomatic neck pain group and a control group with neurologic symptoms only.

Main Results:

• 65% of patients with pre-existing neck pain reported reproduced pain during diskography.
• 50% of patients in the control group (neurologic symptoms only) experienced provocative neck pain.
• The provocation technique showed a high rate of false-positive results.

Conclusions:

• Cervical diskography's provocation technique appears unreliable for diagnosing symptomatic cervical disc levels.
• The high incidence of provocative pain in the control group questions its specificity.
• Further research is needed to refine diagnostic methods for cervical discogenic pain.