• Daniel K Resnick, Tanvir F Choudhri, Andrew T Dailey, Michael W Groff, Larry Khoo, Paul G Matz, Praveen Mummaneni, William C Watters, Jeffrey Wang, Beverly C Walters, Mark N Hadley, and American Association of Neurological Surgeons/Congress of Neurological Surgeons.
• Department of Neurosurgery, University of Wisconsin Medical School, Madison, Wisconsin 53792, USA. Resnick@neurosurg.wisc.edu
• J Neurosurg Spine. 2005 Jun 1;2(6):662-9.

AbstractDiscography is an exquisitely sensitive but not specific diagnostic test for the diagnosis of discogenic low-back pain. The restriction of the definition of a positive discographic study to one that elicits concordant pain from a morphologically abnormal disc improves the definition's accuracy. Fusion surgery based on discography alone, however, is not reliably associated with clinical success. Therefore, discography is not recommended as a standalone test for treatment decisions in patients with low-back pain. Magnetic resonance imaging is a sensitive and noninvasive test for the presence of degenerative disc disease. Discography should not be attempted in patients with normal lumbar MR images. Discography appears to have a role in the evaluation of patients with low-back pain, but it is best limited to the evaluation of abnormal interspaces identified on MR imaging, the investigation of adjacent-level disc disease, and as a means to rule out cases of nonorganic pain from surgical consideration.

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