Diagnostic and therapeutic spinal interventions

Abstract

SummaryDiskography (provocation diskography, disk stimulation) is an invasive diagnostic test performed to confirm or exclude internal disk disruption as the cause of axial spine pain. Diskography involves injecting fluid into the nucleus of the disk under manometric control; a positive response is reproduction of typical pain. Extensive but indirect literature validates diskography in the lumbar spine; it is less wellsupported in the cervical or thoracic spine. Risks include rare instances of infection and neural injury; lumbar diskography may be associated with accelerated disk degeneration. Diskography has utility in establishing a diagnosis of diskogenic pain. When negative, it prevents inappropriate interventions directed at the disk; when positive, it prevents interventions directed at other axial pain generators. Its role in selecting patients for therapies directed at diskogenic pain is limited by the lack of available validated treatments.A xial spine pain is common; low back pain is estimated to affect 66%-80% and neck pain 67% of people during their life.

Spinal pain

“…5 There is no way to confirm or refute their opening claim that "the most common cause of chronic low back pain is internal disc disruption or diskogenic pain," but it strikes us as overly simplistic. The authors concede that the principal reason to perform diskography is to identify patients most likely to benefit from arthrodesis for axial low back pain.…”