Discography with manometry and discographic CT: their value in patient selection for percutaneous lumbar nucleotomy

In minimally invasive spinal surgery and percutaneous disc surgery the exact preoperative structural analysis of the disc herniation becomes a prerequisite in patient selection. Discography including discal manometry and discographic CT (in addition to CT and MRI) are used to review the anatomy of disc herniations prior to surgery. The analysis of the findings of discography in 360 lumbar discs examined from 1988 to 1994 are presented. In 68 discs operated with hemilaminectomy, later intraoperative findings were available for comparison with preoperative discographic findings. The diagnostic accuracy of determining the exact anatomical location of the herniation with discography alone was 75%. The diagnostic accuracy increased to 99.55% with the use of CT discography. The authors conclude that CT discography is an accurate and useful diagnostic aid.