Lumbar discography

Lumbar discography should not be used as a stand-alone test

Lumbar discography is an injection technique used to evaluate patients with back pain who have not responded to extensive conservative (nonsurgical) care regimens. The most common use of discography is for surgical planning prior to a lumbar fusion.

This diagnostic procedure – also called a discogram – is a controversial one.

Some of the basis for performing a discogram is to identify levels that may produce “discogenic pain” or “painful disc syndrome”, a controversial point. When the pain produced mimics the patient’s presenting pain, the pain is said to be “concordant.”

The protagonists of discography believe the information gleaned from this examination is unobtainable any other way. The procedure’s antagonists feel the responses evoked from disc pressurization are not useful in evaluating back pain patients. This article does not extol the use of discography; rather it addresses some aspects of the procedure that may make a patient more at ease with what is an uncomfortable exam.

Indications for a Discogram The indications for getting a discogram prior to a lumbar fusion surgery are extremely variable amongst spine surgeons. Ordering the procedure depends on access to a skilled discographer. A discogram is basically a very subjective test, and if there are no experienced discographers available, then the spine surgeon may forego the test since a poorly done discogram does not yield any useful information.