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Five years ago I had severe back pain from a disc problem that was diagnosed with a test called discography. I just went back to the surgeon for a new back problem. When I asked about having that same test they told me, "Oh we don't use that test anymore." What's wrong with that test?
During discography, contrast medium is injected into the disc and the patient's response to the injection is observed. Computed tomography (CT) is usually performed after discography to look for anatomical changes in the disc and to show any tears or fissures in the disc itself.
In theory, pain that is similar to the patient's current back pain suggests that the disc might be the source of the pain. But there are too many false positives to trust the test. And studies show that patients with a positive test who had surgery didn't have better results than those who didn't have surgery.
This has led surgeons to think that although discography may show signs of degenerative disc disease, that doesn't mean the patient's pain is coming from the disc. Therefore, provocative discography is no longer routinely recommended for the diagnosis of herniated disc-related low back pain.
Roger Chou, MD, et al. Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain. In Spine. May 1, 2009. Vol. 34. No. 10. Pp. 1066-1077.
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