Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 6: Discography for patient selection

Jason C. Eck, Alok Sharan, Daniel K. Resnick, William C. Watters, Zoher Ghogawala, Andrew T. Dailey, Pravee N.V. Mummaneni, Michael W. Groff, Jeffrey C. Wang, Tanvir F. Choudhri, Sanjay S. Dhall, Michael G. Kaiser

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Identifying the etiology of pain for patients suffering from chronic low-back pain remains problematic. Noninvasive imaging modalities, used in isolation, have not consistently provided sufficient evidence to support performance of a lumbar fusion. Provocative testing has been used as an adjunct in this assessment, either alone or in combination with other modalities, to enhance the diagnostic capabilities when evaluating patients with low-back pain. There have been a limited number of studies investigating this topic since the publication of the original guidelines. Based primarily on retrospective studies, discography, as a stand-alone test, is not recommended to formulate treatment strategies for patients with low-back pain. A single randomized cohort study demonstrated an improved potential of discoblock over discography as a predictor of success following lumbar fusion. It is therefore recommended that discoblock be considered as a diagnostic option. There is a possibility, based on a matched cohort study, that an association exists between progression of degenerative disc disease and the performance of a provocative discogram. It is therefore recommended that patients be counseled regarding this potential development prior to undergoing discography.

Original languageEnglish (US)
Pages (from-to)37-41
Number of pages5
JournalJournal of Neurosurgery: Spine
Volume21
Issue number1
DOIs
StatePublished - Jul 2014

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Keywords

  • Discoblock
  • Discography
  • Fusion
  • Lumbar spine
  • Practice guidelines

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Eck, J. C., Sharan, A., Resnick, D. K., Watters, W. C., Ghogawala, Z., Dailey, A. T., Mummaneni, P. N. V., Groff, M. W., Wang, J. C., Choudhri, T. F., Dhall, S. S., & Kaiser, M. G. (2014). Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 6: Discography for patient selection. Journal of Neurosurgery: Spine, 21(1), 37-41. https://doi.org/10.3171/2014.4.SPINE14269