Lumbar discography is considered for patients who, despite extensive conservative treatment, have disabling low back pain, groin pain, hip pain, and/or leg pain. When a variety of spinal diagnostic procedures have failed to elucidate the primary pain generator, these individuals may benefit from lumbar discography especially if spine surgery is contemplated.
MRI/ CT Myelograms
The Lumbar MRI and CT Myelogram are very sensitive anatomic tests but are not very specific in defining actual pain generators. The lumbar discogram, if performed properly, is designed to induce pain in a sensitive disc. A spinal fusion procedure that is designed to obliterate an internally disrupted, painful disc (pain generator) would not be the procedure of choice if pressurization of the disc didn’t reproduce the patient’s clinical discomfort. The spine surgeon needs to be absolutely sure that the level or levels being fused are responsible for the patient’s pain.