Discography

The lumbar disc has been considered as an important cause of low back pain or radiculopathy since 1934. Lumbar discography has been performed since 1948. Cervical and thoracic discography are performed to a lesser extent. However, the accuracy and value of discography has been debated in the lumbar region and more so in the cervical and thoracic regions. Consequently, there continues to be lack of consensus regarding the diagnosis and treatment of intervertebral disc disorders. Based on controlled evaluations, lumbar intervertebral discs have been shown to be the source of chronic back pain without disc herniation in 26% to 39% of the patients, and in 16% to 53% of patients with pain in the cervical spine. Lumbar, cervical, and thoracic provocation discography includes disc stimulation and morphological evaluation, often used to distinguish a painful disc from other potential sources of pain. The evidence for accuracy of provocation discography is Level III for lumbar discography; whereas it is Level IV for cervical discography and there is no evidence available for thoracic discography. Multiple complications also have been described with discography specifically in the cervical region.