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The graphic record, usually radiographic, of diskography.
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The affected discs were selected based on previous discograms and MRI analysis.
The following parameters were recorded: age, sex, duration of LBP, MRI findings, provocated disc level, discogram patterns, LBP intensity on a visual analog scale (VAS 100 mm), Quebec Back Pain Disability score (20 items, scored from 0, no disability, to 5, impossible to do; range of final scores 0-100), finger-tip-to-floor distance (cm), and duration of sitting without pain (min).
We evaluated the provocative disc levels and Dallas discogram patterns.
(Note: a fluoroscopic image of intravascular uptake captured by this author during a lumbar discogram is shown in Figure 7.)
When performing the discogram, a radiologist injects contrast into the nucleus pulposus of a suspected diseased disc under fluoroscopic guidance.
During the course of work-up and treatment for low back pain, a patient can expect to receive a routine lumbar spine series (AP/lateral with flexion/extension), CT and discogram. Intraoperative films will be obtained, as will follow-up routine radiographs, AP Ferguson projections (see Fig.
The deteriorated disc may not be the cause of pain but may be a sign of benign degenerative changes.[2] However, MR is essential prior to a discogram procedure because it helps determine which levels of the spine are suspect and should be injected with contrast should a discogram be necessary.[1]
The use of discography in determining which levels of the spine are responsible for the patient's symptoms is crucial for a successful diagnosis and treatment with surgery.[2] Discograms give important preoperative information that helps establish what particular fusion procedure should be performed.[1] The surgical outcome, expressed in terms of clinical benefit to the patient, has been shown to improve significantly when surgery follows a positive discogram vs a nonsymptomatic or negative discogram.[2] Patients should consider discography only if they are considering and are able to proceed with surgery following a positive discogram.
At least 1 level or disc that is shown to be negative prior to the discogram should be tested to record the patient's reaction.
Have MR and CT scanning limited the need for discograms?
Facilities that performed an average of 3 discograms per month reported a much lower complication rate than facilities that performed less than 1 procedure per month.
A re-analysis of 833 discograms. Spine (Phila Pa 1976).