Guidelines for the use of discography for the diagnosis of painful degenerative lumbar disc disease.
OBJECTIVE
Discography has been used as a diagnostic test in the evaluation of patients with recalcitrant low-back pain. Recently, its usefulness has been questioned because of the occurrence of false-positive results as well as the influence of psychological factors on test results. The purpose of this review is to establish the literature support for and against the use of discography. A search of the English-language literature published between 1966 and 2001 was performed. Papers were selected based on inclusion criteria described in the text, and the quality of information was graded using previously described methods.


CONCLUSIONS
The authors propose a set of practice parameters based on the literature. Although the data were not judged adequate for the determination of a treatment standard, parameters for the use of discography are provided at a guideline and option level.
Resnick
Daniel K
DK
Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin 53792, USA. Resnick@neurosurg.wisc.edu
Malone
David G
DG
Ryken
Timothy C
TC
D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging* / Q000473:pathology; D017116:Low Back Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D017410:Practice Guidelines as Topic / Q000592:standards*; D011859:Radiography; D013122:Spinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology