Since 1984, lateral lumbar discography has been performed in 1100 cases which were preliminarily evaluated by myelography, CT scan, CT myelography etc. The discographic findings were compared with those of the above-described various adjuncts.
Technique: The patient is positioned right side up on the radioluscent filming table under the aid of the fluoroscopic image intensifier. The 4-inch, 18-guage spinal puncture needle and 6-inch, 22-guage spinal needles are directed with a two-needle method from a point 8-12 cm lateral to the spinous process of the disc to be injected, with the needle maintained at an angle of 60 degree toward the disc. Injection of the L5-S1 disc requires a 30 degree caudal angulation. If the tip of the needle is located middle
1
1/3 of the dies both anteriorly and laterally, 2 ml of the Urografin-60 is injected.
Myelographic indentation and bulging patterns of the CT and CT myelography were closely related with discographic findings. But these findings were not uniquely linked to each other. As a primary diagnostic procedure, the discography has definite limitation and disadvantages. But unique advantage of the discography was found
i from these experiences.
Discography offered definite information on
1) Ready communication between the disc space and the systemic venous system
2) Ruptured or extruded disc
3) Direction of extradural leakage
4) Remaining amount of intradiscally injected substance
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