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Conclusion

Discography has become an indispensable assessment tool to evaluate pain of spinal origin; no longer is it reserved for those who are fusion candidates. With the continuous evolution of spinal interventions and the growing recognition of discogenic pain as a major clinical problem, the demand for this procedure is certain to increase. Our experience has been that when discography is performed with appropriate clinical indication(s) by skilled, knowledgeable, and experienced proceduralists, it leads to improved clinical outcomes. Discography is a procedure ideally suited for interventional neuroradiologists, especially those who also interpret spinal imaging studies.

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References

  1. Aprill C, Bogduk N. High-intensity zone: a diagnostic sign of painful lumbar disc on magnetic resonance imaging. Br J Radiol 65:361, 1991.

    Article  Google Scholar 

  2. Boden SD, Davis DO, Dina TS, et al. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects: a prospective investigation. J Bone Joint Surg (Am) 72:403, 1990.

    CAS  Google Scholar 

  3. Braithwaite I, White J, Saifuddin A, et al. Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography. Eur Spine J 7:363, 1998.

    Article  CAS  PubMed  Google Scholar 

  4. Brightbill TC, Pile N, Eichelberger RP, et al. Normal magnetic resonance imaging and abnormal discography in lumbar disc disruption. Spine 19: 1075, 1994.

    CAS  PubMed  Google Scholar 

  5. Buirski G, Silberstein M. The symptomatic lumbar disc in patients with low-back pain: magnetic resonance imaging appearances in both symptomatic and control population. Spine 18:1808, 1993.

    CAS  PubMed  Google Scholar 

  6. Heithoff KB, Gundry CR, Burton CV, et al. Juvenile discogenic disease. Spine 19:335, 1994.

    CAS  PubMed  Google Scholar 

  7. Ito M, Incorvaia KM, Yu SF, et al. Predictive signs of discogenic lumbar pain on magnetic resonance imaging with discography correlation. Spine 23:1252, 1998.

    Article  CAS  PubMed  Google Scholar 

  8. Jensen MC, Brant-Zawadski MN, Obuchowski N, et al. Magnetic resonance imaging of the lumbar spine with people without back pain. N Engl J Med 331:69, 1994.

    Article  CAS  PubMed  Google Scholar 

  9. Milette PC, Fontaine S, Lepanto L, et al. Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine 24:44, 1999.

    Article  CAS  PubMed  Google Scholar 

  10. Parfenchuck TA, Janssen ME. A correlation of cervical magnetic resonance imaging and discography/computed tomographic discograms. Spine 19:2819, 1994.

    CAS  PubMed  Google Scholar 

  11. Saifuddin A, Braithwaite I, White J, et al. The value of lumbar spine magnetic resonance imaging in the demonstration of annular tears. Spine 23:453, 1998.

    Article  CAS  PubMed  Google Scholar 

  12. Schellhas KP: Discography. In: Jensen ME, ed. Spine Interventions (Neuroimaging Clinics of North America). Vol 10. Philadelphia: WB Saunders; 2000:579.

    Google Scholar 

  13. Schellhas KP: Discography. In: Lee RR, ed. Spinal Imaging (SPINE: State of the Art Reviews, vol 9, no 1). Philadelphia: Hanley & Belfus; 1995:27.

    Google Scholar 

  14. Schellhas KP, Pollei SR. The role of discography in the evaluation of patients with spinal deformity. Orthop Clin North Am 25:265, 1994.

    CAS  PubMed  Google Scholar 

  15. Schellhas KP, Pollei SR, Dorwart RH. Thoracic discography: a safe and reliable technique. Spine 19:2103, 1994.

    CAS  PubMed  Google Scholar 

  16. Schellhas KP, Pollei SR, Gundry CR, et al. Lumbar disc high-intensity zone: correlation of magnetic resonance imaging and discography. Spine 21:79, 1996.

    Article  CAS  PubMed  Google Scholar 

  17. Schellhas KP, Smith MD, Gundry CR, et al. Cervical discogenic pain: prospective correlation of magnetic resonance imaging and discography in asymptomatic subjects and pain sufferers. Spine 21:300, 1996.

    Article  CAS  PubMed  Google Scholar 

  18. Schellhas KP, Garvey TA, Johnson BA, et al: Cervical diskography: analysis of provoked responses at C2-C3, C3-C4, and C4-C5. AJNR Am J Neuroradiol 21:269, 2000.

    CAS  PubMed  Google Scholar 

  19. Smith BM, Hurwitz EL, Solsberg D, et al. Interobserver reliability of detecting lumbar intervertebral disc high-intensity zone on magnetic resonance imaging and association of high-intensity zone with pain and annular disruption. Spine 23:2074, 1998.

    Article  CAS  PubMed  Google Scholar 

  20. Weishaupt D, Zanetti M, Hodler J, et al. Painful lumbar disc derangement: relevance of endplate abnormalities at MR imaging. Radiology 218(2):420, 2001.

    CAS  PubMed  Google Scholar 

  21. Whitecloud TS, Seago RA. Cervical discogenic syndrome: results of operative intervention in patients with positive discography. Spine 12:313, 1987.

    PubMed  Google Scholar 

  22. Wood KB, Schellhas KP, Garvey, TA, et al. Thoracic discography in healthy individuals: a controlled prospective study of magnetic resonance imaging and discography in asymptomatic and symptomatic individuals. Spine 24:1548, 1999.

    Article  CAS  PubMed  Google Scholar 

  23. Winter RB, Schellhas KP. Painful adult thoracic Scheuermann’s disease: diagnosis by discography and treatment by combined arthrodesis. Am J Orthop 25:783, 1996.

    CAS  PubMed  Google Scholar 

  24. Bogduk N, Modic MT. Lumbar discography. Spine 21:402, 1996.

    CAS  PubMed  Google Scholar 

  25. Colhoun E, McCall IW, Williams L, et al. Provocation discography as a guide to planning operations on the spine. J Bone Joint Surg (Br) 70:267, 1988.

    CAS  Google Scholar 

  26. Derby R, Howard MW, Grant JM, et al. The ability of pressure-controlled discography to predict surgical and nonsurgical outcomes. Spine 24:364, 1999.

    Article  CAS  PubMed  Google Scholar 

  27. Donelson R, Aprill C, Medcalf R, et al. A prospective study of centralization of lumbar and referred pain. A predictor of symptomatic discs and annular competence. Spine 22:1115, 1997.

    Article  CAS  PubMed  Google Scholar 

  28. Grubb SA, Kelly C. Cervical discography: clinical implications from 12 years of experience. Spine 25:1382, 2000.

    Article  CAS  PubMed  Google Scholar 

  29. Guyer RD, Collier R, Stith WJ, et al. Diskitis after discography. Spine 13:1352, 1988.

    CAS  PubMed  Google Scholar 

  30. Guyer RD, Ohnmeiss DD. Lumbar discography. Position statement from the North American Spine Society Diagnostic and Therapeutic Committee. Spine 21:1274, 1996.

    Google Scholar 

  31. Guyer RD, Ohnmeiss DD, Mason SL, et al. Complications of cervical discography: findings in a large series. J Spinal Disord 10:95, 1997.

    CAS  PubMed  Google Scholar 

  32. Moneta GB, Videman T, Kaivanto K, et al. Reported pain during lumbar discography as a function of annular ruptures and disc degeneration: a reanalysis of 833 discograms. Spine 19:1968, 1994.

    CAS  PubMed  Google Scholar 

  33. Ohnmeiss DD, Vanharanta H, Guyer RD. The association between pain drawings and computed tomographic/discographic pain responses. Spine 20:729, 1995.

    CAS  PubMed  Google Scholar 

  34. Ohnmeiss DD, Vanharanta H, Ekholm J. Degree of disc disruption and lower extremity pain. Spine 22:1600, 1997.

    Article  CAS  PubMed  Google Scholar 

  35. Ohnmeiss DD, Vanharanta H, Ekholm J. Relation between pain location and disc pathology: a study of pain drawings and CT/discography. Clin J Pain 15:210, 1999.

    Article  CAS  PubMed  Google Scholar 

  36. Saifuddin A, Emanuel R, White J, et al. An analysis of radiating pain at lumbar discography. Eur Spine J 7:358, 1998.

    Article  CAS  PubMed  Google Scholar 

  37. Saifuddin A, Renton P, Taylor BA. Effects on the vertebral end-plate of uncomplicated lumbar discography: an MRI study. Eur Spine J 7:36, 1998.

    Article  CAS  PubMed  Google Scholar 

  38. Schwarzer AC, Aprill CN, Derby R, et al. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine 20:1878, 1995.

    Article  CAS  PubMed  Google Scholar 

  39. Waldman SD, Winnie AP, eds. Interventional Pain Management: Philadelphia: WB Saunders; 1996.

    Google Scholar 

  40. Walsh TR, Weinstein JN, Spratt KF, et al. Lumbar discography in normal subjects: a controlled, prospective study. J Bone Joint Surg 72:1081, 1990.

    CAS  PubMed  Google Scholar 

  41. Weinstein J, Claverie W, Gibson S. The role of discography. Spine 13:1344, 1988.

    CAS  PubMed  Google Scholar 

  42. Zucherman J, Derby R, Hsu K, et al. Normal magnetic resonance imaging with abnormal discography. Spine 13:1355, 1988.

    CAS  PubMed  Google Scholar 

  43. Bogduk N. The lumbar disc and low back pain. Neurosurg Clin North Am 2:791, 1991.

    CAS  Google Scholar 

  44. Osti OL, Fraser RD, Vernon-Roberts B. Diskitis after discography. J Bone Joint Surg (Br) 72:271, 1990.

    CAS  Google Scholar 

  45. Sachs BL, Vanharanta H, Spivey MA, et al. Dallas discogram description: a new classification of CT/discography in low back disorders. Spine 12:287, 1987.

    CAS  PubMed  Google Scholar 

  46. Bogduk N, Tynan W, Wilson AS. The nerve supply to the human lumbar intervertebral discs. J Anat 132:39, 1981.

    CAS  PubMed  Google Scholar 

  47. Boduk N, Windsor M, Inglis A. The innervation of cervical intervertebral discs. Spine 13:2, 1988.

    Google Scholar 

  48. Heggeness MH, Watters WC 3rd, Gray PM Jr Discography of lumbar discs after surgical treatment for disc herniation. Spine 22:1606, 1997.

    Article  CAS  PubMed  Google Scholar 

  49. Kuslich SD, Danielson G, Dowdle JD, et al. Four-year follow-up results of lumbar spine arthrodesis using the Bagby and Kuslich lumbar fusion cage. Spine 25:2656, 2000.

    Article  CAS  PubMed  Google Scholar 

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Schellhas, K.P. (2004). Discography. In: Johnson, B.A., Staats, P.S., Wetzel, F.T., Mathis, J.M. (eds) Image-Guided Spine Interventions. Springer, New York, NY. https://doi.org/10.1007/0-387-21794-0_6

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  • DOI: https://doi.org/10.1007/0-387-21794-0_6

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-40320-5

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