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Discography

  • Aaron Calodney
  • Duane Griffith
Chapter

Abstract

Discography has become an indispensable diagnostic tool since its introduction in the 1940s to diagnose lumbar disc herniation.1,2 Today, discography is used most often to identify painful internally disrupted discs.3 Discography is unique in that it is the only diagnostic technique that directly correlates a patient’s symptoms with disc morphology.4 It can be thought of as similar to palpation: an important component of physical examination.5 Tenderness elicited on palpation is analogous to pain provocation on discography.

Keywords

Lumbar Disc Annulus Fibrosis Cervical Disc Normal Disc Target Disc 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Lindblom K. Technique and results in myelography and disc puncture. Acta Radiol 1950;34:321-330.CrossRefPubMedGoogle Scholar
  2. 2.
    Aprill C, Bogduk N. High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging. Br J Radiol 1992;65:361-369.CrossRefPubMedGoogle Scholar
  3. 3.
    Guyer RD, Ohnmeiss DD. Lumbar discography. Position statement from the North American Spine Society Diagnostic and Therapeutic Committee. Spine 1995;20:2048-2059.CrossRefPubMedGoogle Scholar
  4. 4.
    Lindblom K. Technique and results of diagnostic disc puncture and injection (discography) in the lumbar region. Acta Orthop Scand 1951;20:315-326.CrossRefPubMedGoogle Scholar
  5. 5.
    Bogduk NC, Aprill C, Derby R. Discography. In White A, Schofferman A (eds): Spine Care. Diagnosis and Conservative Treatment. St. Louis: Mosby, 1995:219-236.Google Scholar
  6. 6.
    Lam KS, Carlin D, Mulholland RC. Lumbar disc high-intensity zone: the value and significance of provocative discography in the determination of the discogenic pain source. Eur Spine J 2000;9:36-41.CrossRefPubMedGoogle Scholar
  7. 7.
    Schellhas KP, Pollei SR, Gundry CR, Heithoff KB. Lumbar disc high-intensity zone. Correlation of magnetic resonance imaging and discography. Spine 1996;21:79-86.CrossRefPubMedGoogle Scholar
  8. 8.
    Buirski G, Silberstein M. The symptomatic lumbar disc in patients with low-back pain: magnetic resonance imaging appearance in both symptomatic and control population. Spine 1993;18:1808.CrossRefPubMedGoogle Scholar
  9. 9.
    Milette PC, Fontaine S, Lepanto L, Cardinal E, Breton G, Haughton V. Differentiating lumbar disc protrusions, disc bulges and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine 1999;24:44.CrossRefPubMedGoogle Scholar
  10. 10.
    Ohnmeiss DD, Vanharanta H, Ekholm J. Relation between pain locations and disc pathology: a study of pain drawings and CT/discography. Clin J Pain 1999;15:210.CrossRefPubMedGoogle Scholar
  11. 11.
    Walsh TR, Weinstein JN, Spratt KF, Lehmann TR, Aprill C, Sayre H. Lumbar discography in normal subjects: a controlled, prospective study. J Bone Joint Surg 1990;72:1081.PubMedGoogle Scholar
  12. 12.
    Manchikanti L, Singh V, Pampati V, Fellows B, Beyer C, Damron K, Cash KA. Provocative discography in low back pain patients with or without somatization disorder: a randomized prospective evaluation. Pain Physician 2001;4:227-239.PubMedGoogle Scholar
  13. 13.
    Horton WC, Daftari TK. Which disc visualized by magnetic resonance imaging is actually a source of pain? A correlation between magnetic resonance imaging and discography. Spine 1992;17:S164-S171.CrossRefPubMedGoogle Scholar
  14. 14.
    Kornberg M. Discography and magnetic resonance imaging in the diagnosis of lumbar disc disruption. Spine 1989;14:1368-1372.CrossRefPubMedGoogle Scholar
  15. 15.
    Manchikanti L, Singh V, Pampati V, Damron KS, Barnhill RC, Beyer C, Cash KA. Evaluation of the relative contributions of various structures in chronic low back pain. Pain Physician 2001;4:308-316.PubMedGoogle Scholar
  16. 16.
    Buenaventura RM, Shah RV, Patel V, Benyamin R, Singh V. Systematic review of discography as a diagnostic test for spinal pain: an update. Pain Physician 2007;10:147-164.PubMedGoogle Scholar
  17. 17.
    Bogduk N. Lumbar disc stimulation (provocation discography). In: Practice Guidelines for Spinal Diagnostic and Treatment Procedures. ISIS, 2004:20-46.Google Scholar
  18. 18.
    Derby R, Eek B, Lee SH, Seo KS, Kin B-J. Comparison of intradiscal restorative injections and intradiscal electrothermal treatment (IDET) in the treatment of low back pain. Pain Physician 2004;7:63-66.PubMedGoogle Scholar
  19. 19.
    Holt EP Jr. Fallacy of cervical discography. Report of 50 cases in normal subjects. JAMA 1964;188:799-801.PubMedGoogle Scholar
  20. 20.
    Schellhas KP, Pollei SR, Dorwart RH. Thoracic discography: a safe and reliable technique. Spine 1994;19:2103.CrossRefPubMedGoogle Scholar
  21. 21.
    Wood KB, Schellhas KP, Garvey TA, Aeppli D. Thoracic discography in healthy individuals: a controlled prospective study of magnetic resonance imaging and discography in asymptomatic symptomatic individuals. Spine 1999;24:1548.CrossRefPubMedGoogle Scholar
  22. 22.
    Winter RB, Schellhas KP, Painful adult thoracic Scheuermann’s disease: diagnosis by discography and treatment by combined arthrodesis. Am J Orthop 1996;25:783.PubMedGoogle Scholar
  23. 23.
    Bogduk N. Thoracic provocation discography. In: Practice Guidelines for Spinal Diagnostic and Treatment Procedures. ISIS, 2004:287-294.Google Scholar
  24. 24.
    Singh V. Thoracic discography. Pain Physician 2004;7:451-458.PubMedGoogle Scholar
  25. 25.
    Parfenchuck TA, Janssen ME. A correlation of cervical magnetic resonance imaging and discography/computed tomographic discograms. Spine 1994;19:2819.CrossRefPubMedGoogle Scholar
  26. 26.
    Schellhas KP, Smith MD, Gundry CR, Pollei SR. Cervical discogenic pain: prospective correlation of magnetic resonance imaging and discography in asymptomatic subjects and pain sufferers. Spine 1996;21:300.CrossRefPubMedGoogle Scholar
  27. 27.
    Schellhas KP, Garvey TA, Johnson BA, Rothbart PJ, Pollei SR. Cervical discography: analysis of provoked responses at C2-C3, C3-C4, and C4-C5. Am J Neuroradiol 2000;21:269.PubMedGoogle Scholar
  28. 28.
    Grubb SA, Kelly C. Cervical discography: clinical implications from 12 years of experience. Spine 2000;25:1382.CrossRefPubMedGoogle Scholar
  29. 29.
    Fortin JD. Cervical discography with CT and MRI correlations. In Lennard TA (ed): Pain Procedures in Clinical Practice. Philadelphia: Hanley and Belfus, 2000:230-240.Google Scholar
  30. 30.
    Bogduk N. Cervical disc stimulation (provocation discography). In Practice Guidelines for Spinal Diagnostic and Treatment Procedures. ISIS, 2004:95-111.Google Scholar
  31. 31.
    Roth DA. Cervical analgesic discography. A new test for the definitive diagnosis of painful-disk syndrome. JAMA 1976;235:1713-1714.CrossRefPubMedGoogle Scholar
  32. 32.
    Whitecloud TS III, Seago RA. Cervical discogenic syndrome. Results of operative intervention in patients with positive discography. Spine 1987;12:313-317.CrossRefPubMedGoogle Scholar
  33. 33.
    Motimaya A, Arici M, George D, Ramsby G. Diagnostic value of cervical discography in the management of cervical discogenic pain. Conn Med 2000;64:395-398.PubMedGoogle Scholar
  34. 34.
    Zeidman SM, Thompson K, Ducker TB. Complications of cervical discography: analysis of 4400 diagnostic disc injections. Neurosurgery 1995;37:414-417.CrossRefPubMedGoogle Scholar
  35. 35.
    Kozak J, O’Brien J. Simultaneous combined anterior and posterior fusion. Spine 1990;15:322-328.CrossRefPubMedGoogle Scholar
  36. 36.
    Derby R, Howard MW, Grant JM, Lettice JJ, Van Peteghem PK, Ryan DP. The ability of pressure-controlled discography to predict surgical and non-surgical outcomes. Spine 1999;24:364-371.CrossRefPubMedGoogle Scholar
  37. 37.
    Blumenthal SL, Baker J, Dossett A, Selby DK. The role of anterior fusion for internal disc disruption. Spine 1988;13:566-569.CrossRefPubMedGoogle Scholar
  38. 38.
    Newman MH, Grinstead GL. Anterior lumbar interbody fusion for internal disc disruption. Spine 1992;17:831-833.CrossRefPubMedGoogle Scholar
  39. 39.
    Colhoun E, McCall IW, Williams L, Cassar Pullicino VN. Provocation discography as a guide to planning operations on the spine. J Bone Joint Surg 1988;70B(2):267-271.Google Scholar
  40. 40.
    Cohen S, Hurley R. The ability of diagnostic spinal injections to predict surgical outcomes. Anesth Analg 2007;105:1756-1775.CrossRefPubMedGoogle Scholar
  41. 41.
    Saifuddin A, Braithwaite I, White J, Taylor BA, Renton P. The value of lumbar spine magnetic resonance imaging in the demonstration of annular tears. Spine 1998;23:453-457.CrossRefPubMedGoogle Scholar
  42. 42.
    Ito M, Incorvaia K, Yu S, Fredrickson BE, Yuan HA, Rosenbaum AE, Bogduk N. Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation. Spine 1998;23:1252-1258.CrossRefPubMedGoogle Scholar
  43. 43.
    Guyer RD, Ohnmeiss DD, NASS. Lumbar discography. Spine J 2003;3:11S-27S.CrossRefPubMedGoogle Scholar
  44. 44.
    Grogan JP, Hemminghytt S, Williams AL, et al. Another strategy recommended by Balderston et al. J Spinal Disord Tech 2004;17:248-250.CrossRefGoogle Scholar
  45. 45.
    Arrington JA, Murtagh FR, Silbiger ML, Rechtine GR, Nokes SR. Magnetic resonance imaging of postdiscogram discitis and osteomyelitis in the lumbar spine: case report. J Fla Med Assoc 1986;73:192-194.PubMedGoogle Scholar
  46. 46.
    Guyer RD, Collier R, Stith WJ, Ohmneiss DD, Hochschuler SH, Rashbaum RF, Regan JJ. Post-discography discitis. Spine 1988;13:1352-1354.CrossRefPubMedGoogle Scholar
  47. 47.
    NASS position statement on discography. Spine 1995;20:2048-2059.Google Scholar
  48. 48.
    Klessig HT, Showsh SA, Sekorski A. The use of intradiscal antibiotics for discography: an in vitro study of gentamicin, cefazolin, and clindamycin. Spine 2003;28:1735-1738.CrossRefPubMedGoogle Scholar
  49. 49.
    Boswell M, Wolfe J. Intrathecal cefazolin induced seizures following attempted discography. Pain Physician 2004;7:103.PubMedGoogle Scholar
  50. 50.
    Mathis J. Procedural techniques and materials: tumors and osteoporotic fractures. In Mathis J (ed): Percutaneous Vertebroplasty. New York: Springer, 2002.Google Scholar
  51. 51.
    Cavanaugh JM, Kallakuri S, Ozaktay AC. Innervation of the rabbit lumbar intervertebral disc and posterior longitudinal ligament. Spine 1995;20:2080-2085.CrossRefPubMedGoogle Scholar
  52. 52.
    Raj P. Intervertebral disc. Pain Pract 2008;8:18-44.CrossRefPubMedGoogle Scholar
  53. 53.
    Heggeness MH, Walters WC III, Gray PM Jr. Discography of lumbar discs after surgical treatment for disc herniation. Spine 1997;22:1606-1609.CrossRefPubMedGoogle Scholar
  54. 54.
    Ahmed M, Bjurholm A, Kreicbergs A, Schultzberg M. Neuropeptide Y, tyrosine hydroxylase and vasoactive intestinal polypeptide-immunoreactive nerve fibers in the vertebral bodies, discs, dura mater, and spinal ligaments of the rat lumbar spine. Spine 1993;18:268-273.CrossRefPubMedGoogle Scholar
  55. 55.
    Palmgren T, Gronblad M, Virri J, Kääpä E, Karaharju E. An immunohistochemical study of nerve structure. Spine 1999;24:2075-2079.CrossRefPubMedGoogle Scholar
  56. 56.
    Peng B, Wu W, Hou S, Li P, Zhang C, Yang Y. The pathogenesis of discogenic low back pain. J Bone Joint Surg 2005;87:62-67.Google Scholar
  57. 57.
    Fagan A, Moore R, Roberts V, Blumbergs P, Fraser R. The innervation of the intervertebral disc: a quantitative analysis. Spine 2003;28(23):2570-2576.CrossRefPubMedGoogle Scholar
  58. 58.
    Pauza K. Nomenclature and Terminology for Spine Specialists (Appropriate Words Meant to Replace the Most Commonly Misused Words of the Spine Specialists). PASSOR Educational Guidelines Task Force, 2005.Google Scholar
  59. 59.
    Mathis J. Percutaneous vertebroplasty: complication avoidance and technique optimization. Am J Neuroradiol 2003;24:1697.PubMedGoogle Scholar
  60. 60.
    Schellhas KP. Discography. Spinal Interv (Neuroimaging Clin N Am) 2000;10:579-596.Google Scholar
  61. 61.
    Derby R. Discography. In Slipman E, Derby R, Simeone FA, Mayer TG (eds): Interventional Spine: An algorithmic approach. Philadelphia: WB Saunders, 2008:291-302.Google Scholar
  62. 62.
    Khot A, Bowditch M, Powell J, Sharp D. The use of intradiscal steroid therapy for lumbar spinal discogenic pain: a randomized controlled trial. Spine 2004;29:833-836.CrossRefPubMedGoogle Scholar
  63. 63.
    Derby R, Lee SH, Kim BJ, et al. Pressure-controlled lumbar discography in volunteers with low back pain symptoms. Pain Med 2005;6:213-221.CrossRefPubMedGoogle Scholar
  64. 64.
    Zhou Y, Abdi S. Diagnosis and minimally invasive treatment of lumbar discogenic pain: a review of the literature. Clin J Pain 2006;22:468-481.CrossRefPubMedGoogle Scholar
  65. 65.
    Wolfer LE, Derby R, Lee J-E, Lee S-H. Systematic review of lumbar provocation discograpy in asymptomatic subjects with a meta-anaylysis of false-positive rates. Systematic review. Pain Physician 2008;11(4):513-538.PubMedGoogle Scholar
  66. 66.
    Bull T, Sharp D, Powell J. The efficacy of intradiscal steroid injection compared to modic changes in degenerative lumbar discs. J Bone Joint Surg Br 1998;80:40.Google Scholar
  67. 67.
    Bogduk N, Modic MT. Lumbar discography. Spine 1996;21:402-404.PubMedGoogle Scholar
  68. 68.
    Vanharanta H, Sachs BL, Spivey MA, et al. The relationship of pain provocation to lumbar disc deterioration as seen by CT/discography. Spine 1987;12:295-298.CrossRefPubMedGoogle Scholar
  69. 69.
    O’Neill C, Kurgansky M. Subgroups of positive discs on discography. Spine 2004;29:2134.CrossRefPubMedGoogle Scholar
  70. 70.
    Carrino JA, Swathwood TC, Morrison WB, Glover JM. Prospective evaluation of contrast-enhanced MR imaging after uncomplicated lumbar discography. Skeletal Radiol 2007;36:293-299.CrossRefPubMedGoogle Scholar
  71. 71.
    Discyphor Procedural Technique Guide. Sunnyvale, California: Kyphon Inc, 2006.Google Scholar
  72. 72.
    Functional Anesthetic Discography [Package Insert]. Sunnyvale, California: Kyphon Inc, 2006.Google Scholar
  73. 73.
    Alamin T, Arawal V, Carragee E. FAD versus provocative discography: comparative results and postoperative clinical outcomes. Spine J 2007;7:39S.CrossRefGoogle Scholar
  74. 74.
    Luchs J, DeMoura A, Cho M, Ortiz A. Preliminary experience with functional anesthetic discography. Interv Spine 2007;7(5):63S.Google Scholar
  75. 75.
    Wetzel FT, LaRocca SH, Lowery GL, Aprill CN. The treatment of lumbar spinal pain syndromes diagnosed by discography. Spine 1994;19(7):792-800.CrossRefPubMedGoogle Scholar
  76. 76.
    Albrand OW, Corkill G. Thoracic disc herniation: treatment and prognosis. Spine 1979;4:41-46.CrossRefPubMedGoogle Scholar
  77. 77.
    Epstein JA. The syndrome of herniation of the lower thoracic intervertebral discs with nerve root and spinal cord compression. J Neurosurg 1973;11:525-538.Google Scholar
  78. 78.
    Vanichkachorn JS, Vaccaro AR. Thoracic disc disease: diagnosis and treatment. J Am Acad Orthop Surg 2000;8:159-169.PubMedGoogle Scholar
  79. 79.
    Bogduk N. Intervention and pain patterns of the thoracic spine. In Grant R (ed): Physical Therapy of the Cervical and Thoracic Spine, 3rd ed. New York: Churchill Livingstone, 2002:73-81.Google Scholar
  80. 80.
    Wyke B. The neurological basis of thoracic spinal pain. Rheumatol Phys Med 1970;10(7):356-367.CrossRefPubMedGoogle Scholar
  81. 81.
    Slezak J, Stojanovic M. Injection procedures. In Slipman E, Derby R, Simeone FA, Mayer TG (eds): Discography in Interventional Spine: An Algorithmic Approach. Philadelphia: WB Saunders, 2008:787-792.Google Scholar
  82. 82.
    Kapural L, Goyle A. Imaging for provocative discography and minimally invasive percutaneous procedures for treatment of discogenic lower back pain. Tech Reg Anesth Pain Manag 2007;11:73-80.CrossRefGoogle Scholar
  83. 83.
    Cloward RB. Cervical discography: technique, indications and use in diagnosis of rupture cervical disks. AJR Am J Roentgenol 1958;79:563-574.Google Scholar
  84. 84.
    Cloward RB. The clinical significance of the sinu-vertebral nerve of the cervical spine in relation to the cervical disk syndrome. J Neurol Neurosurg Psychiatry 1960;23:321-326.CrossRefPubMedGoogle Scholar
  85. 85.
    Ohnmeiss DD, Guyer RD, Mason SL. The relation between cervical discographic pain responses and radiographic images. Clin J Pain 2000;16:1-5.CrossRefPubMedGoogle Scholar
  86. 86.
    An H, Simpson M. Surgery of the Cervical Spine. Baltimore: Williams and Wilkins, 1994:1-39.Google Scholar
  87. 87.
    Sylven B. On the biology of nucleus pulposis. Acta Orthop Scand 1951;20:275-279.CrossRefPubMedGoogle Scholar
  88. 88.
    Bogduk N, Windsor M, Inglis A. The innervation of the cervical intervertebral discs. Spine 1989;13:2-8.CrossRefGoogle Scholar
  89. 89.
    Groen GJ, Baljet B, Drukker J. Nerves and nerve plexuses of the human vertebral column. Am J Anat 1990;188:286-296.CrossRefGoogle Scholar
  90. 90.
    Mendel T, Wink CS, Zimny ML. Neural elements in human cervical intervertebral discs. Spine 1992;17:132-135.CrossRefPubMedGoogle Scholar
  91. 91.
    Ferlic DC. The nerve supply of the cervical intervertebral discs in man. Bull Johns Hopkins Hosp 1963;113:347-351.PubMedGoogle Scholar
  92. 92.
    Chabot MC, Montgomery DM. The pathophysiology of axial and radicular neck pain. Semin Spine Surg 1995;7:2-8.Google Scholar
  93. 93.
    Carragee EJ, Chen Y, Tanner CM, Hayward C, Rossi M, Hagle C. Can discography cause long-term back symptoms in previously asymptomatic subjects? Spine 2000;25:1803-1808.CrossRefPubMedGoogle Scholar
  94. 94.
    Carragee EJ, Chen Y, Tanner CM, Truong T, Lau E, Brito JL. Provocative discography in patients after limiting lumbar discectomy: a controlled, randomized study of pain response in symptomatic and asymptomatic subjects. Spine 2000;25:3065-3071.CrossRefPubMedGoogle Scholar
  95. 95.
    Carragee EJ, Tanner CM, Yang B, Brito JL, Truong T. False-positive findings on lumbar discography: reliability of subjective concordance assessment during provocative disc injection. Spine 1999;24:2542-2547.CrossRefPubMedGoogle Scholar
  96. 96.
    Carragee EJ, Alamin TF, Miller J, Alamin TF, Miller J, Grafe M. Provocative discography in volunteer subjects with mild persistent low back pain. Spine 2002;2:25-34.Google Scholar
  97. 97.
    Carragee EJ, Tanner CM, Khurana S, Hayward C, Welsh J, Date E, Truong T, Rossi M, Hagle C. The rates of false-positive lumbar discography in select patients without low back symptoms. Spine 2000;25:1373-1380.CrossRefPubMedGoogle Scholar
  98. 98.
    Carragee EJ. Psychological and functional profiles in select subjects with low back pain. Spine J 2001;1:198-204.CrossRefPubMedGoogle Scholar
  99. 99.
    Carragee EJ, Barcohana B, Alamin T, van den Haak E. Prospective controlled study of the development of lower back pain in previously asymptomatic subjects undergoing experimental discography. Spine 2004;29:1112-1117.CrossRefPubMedGoogle Scholar
  100. 100.
    Heggeness MH, Doherty BJ. Discography causes end plate deflection. Spine 1993;18:1050-1053.CrossRefPubMedGoogle Scholar
  101. 101.
    Antonacci MD, Mody DR, Heggeness MH. Innervation of the human vertebral body: a histologic study. J Spinal Disord 1998;11:526-351.CrossRefPubMedGoogle Scholar
  102. 102.
    Niv D, Gofeld M, Dever M. Causes of pain in degenerative bone and joint disease: a lesson from vertebroplasty. Pain 2003;105:387-392.CrossRefPubMedGoogle Scholar
  103. 103.
    Hoopes J, Eskey J, Attawia M, Patel S, Ryan P, Pellegrino R, Bergeron J. Radiofrequency ablation of the basivertebral nerve as potential treatment of back pain: pathologic assessment in an ovine model. Proc Soc Photo Opt Instrum Eng 2005;5698:168-180.Google Scholar

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Aaron Calodney
    • 1
  • Duane Griffith
    • 1
  1. 1.Texas Spine and Joint HospitalTylerUSA

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