Evaluation of cervical diskography in pain origin and provocation.
The purpose of this article is to analyze the role of cervical diskography as a diagnostic method via reproduced pain. A nonionic contrast medium (Iohexol) that does not harm normal tissue was used in this series to prevent false-positive provocative pain. One hundred forty-four patients (128 with cervical spondylotic myelopathy, eight with cervical spondylotic radiculopathy, and eight with cervical spondylotic amyotrophy) were studied. Among 72 patients in the symptomatic neck pain group who complained of neck pain before diskography, 65% showed reproduced pain. However, in the control group (neurologic symptoms only) 50% of the patients complained of provocative neck pain during dye injection. These results demonstrated that this provocation technique appeared unreliable for diagnosing symptomatic disk levels.
Shinomiya
K
K
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Japan.
Nakao
K
K
Shindoh
S
S
Mochida
K
K
Furuya
K
K
D000328:Adult; D000368:Aged; D001284:Atrophy; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000009:adverse effects*; D004824:Epidural Space; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging*; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging*; D007472:Iohexol / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000000981:diagnostic imaging / Q000473:pathology; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging / Q000209:etiology; D010146:Pain / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology; D013127:Spinal Nerves / Q000000981:diagnostic imaging; D013128:Spinal Osteophytosis / Q000150:complications / Q000000981:diagnostic imaging*
D003287:Contrast Media; D007472:Iohexol