2010 年 24 巻 2 号 p. 203-207
Object : Assessment of the usefulness of discography for correct diagnosis of lumbar discogenic pain and determination of causative disc levels.
Methods : Between January 2006 and January 2009, we performed 66 discographies in 44 patients whose neuroimaging data did not clearly show the location of the pain generating site. We retrospectively assessed the correlation between of discography findings and the surgical results and other neuroimaging data.
Results : Twenty-seven out of a total of 38 patients were diagnosed with discogenic pain ; concordant pain was elicited by infusion of contrast agents into their discs. Twenty of these 27 patients were treated by transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF) and pedicle screw fixation. Their Japanese orthopedic association (JOA) score postoperatively improved by 54%, which is a higher improvement than the reported results of surgeries performed according to other diagnostic methods including MRI. Discogram type and disc degenerative change in MRI seemed to correlate to the provocation rate of concordant pain by discography.
Conclusion : Discography is an invasive technique, but it still has a diagnostic significance even in an MRI era. It provides important information as to which patients should undergo fusion and the appropriate disc levels to be fused.
