Back to Search
Start Over
Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 6: discography for patient selection
- Source :
- Journal of neurosurgery. Spine. 21(1)
- Publication Year :
- 2014
-
Abstract
- Identifying the etiology of pain for patients suffering from chronic low-back pain remains problematic. Noninvasive imaging modalities, used in isolation, have not consistently provided sufficient evidence to support performance of a lumbar fusion. Provocative testing has been used as an adjunct in this assessment, either alone or in combination with other modalities, to enhance the diagnostic capabilities when evaluating patients with low-back pain. There have been a limited number of studies investigating this topic since the publication of the original guidelines. Based primarily on retrospective studies, discography, as a stand-alone test, is not recommended to formulate treatment strategies for patients with low-back pain. A single randomized cohort study demonstrated an improved potential of discoblock over discography as a predictor of success following lumbar fusion. It is therefore recommended that discoblock be considered as a diagnostic option. There is a possibility, based on a matched cohort study, that an association exists between progression of degenerative disc disease and the performance of a provocative discogram. It is therefore recommended that patients be counseled regarding this potential development prior to undergoing discography.
- Subjects :
- medicine.medical_specialty
Discography
Patient Care Planning
Degenerative disease
Lumbar
medicine
Humans
Intervertebral Disc
Pain Measurement
Modalities
Evidence-Based Medicine
Lumbar Vertebrae
business.industry
Patient Selection
Retrospective cohort study
General Medicine
Guideline
medicine.disease
Magnetic Resonance Imaging
Spinal Fusion
Practice Guidelines as Topic
Physical therapy
Etiology
Spinal Diseases
business
Low Back Pain
Cohort study
Subjects
Details
- ISSN :
- 15475646
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of neurosurgery. Spine
- Accession number :
- edsair.doi.dedup.....844153b94de3004f973a93294331a772