In my book, Ending Back Pain, I discussed the use of provocative discography to help diagnose degenerative disc disease. I pointed out that this has been a controversial topic and yet is frequently helpful in deciding a surgical versus nonsurgical algorithm for a particular patient.
Eugene Carragee recently added important information to this discussion.
His article titled as “Does Provocative Discography Cause Clinically Important Injury To The Lumbar Vertebral Disc?” was published in the Spine Journal this year. He and his colleagues followed discography patients for ten years and found that the group that had discography ended up having far more surgeries than those that did not.
The author suggests that there is a potentially deleterious effect of discography on the lumbar disc itself and may even accelerate disc degeneration. This study gives many of us, who take care of such patients, pause to reconsider the use of this diagnostic test.