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KMID : 0948920070060010030
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Clinical Pain
2007 Volume.6 No. 1 p.30 ~ p.39
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Lumbar Discography
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Hong Young-Ki
Lee Sang-Heon
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Abstract
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Although radiologic methods such as magnetic resonance imaging (MRI) can identify a degenerative disc in patients with low back pain, those images may not differentiate the pathologic discs provoking a patient’s usual pain from the physiologically aging discs that cause no pain. To date, the best way to solve this problem is to evaluate whether the usual pain is reproduced by direct stimulation on the disc using injection of contrast medium. This technique is called discography. Studies have shown that reproduction of the pain is associated with tears which extend to the outer region of the annulus. Validity of this method depends on how accurately we objectify the patient’s subjective experience. In order to do that, standardized procedural techniques and diagnostic criteria should be established. In the present study, we recommend the positive criteria with pressure-controlled manometric discography as follows: a numeric rating scale of pain above 6/10, <50 psi intradiscal pressure above opening pressure, <3.5 ml total volume, and at least one negative control disc.
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KEYWORD
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Low back pain, Discography
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