CT-Discography: Diagnostic Accuracy in Lumbar Disc Herniation and Significance of Induced Pain During Procedure

Jin, En Hao; Chung, Tae Sub; Kim, Young Soo; Roh, Sung Woo; Jeong, Mi Gyoung

Abstract

PURPOSE
To evaluate the usefulness and the accuracy of CT-discography in lumbar disc disease by analyzing the findings of CT-discogram and types of evoked pain during the procedure.
MATERIALS AND METHODS
CT-discograms were retrospectively evaluated in 47 intervertebral discs of 20 patients with multilevel involvement of lumbardisc diseases. In 28 herniated discs confirmed at surgery, the findings of CT-discogram (28 disc levels/20 patients), MRI(23/16) and CT(21/15) were comparatively analysed. The type of pain after infusion of contrast mediaduring CT-discography was compared with that prior to the procedure.
RESULTS
The accuracy for determining typesof the herniated lumbar disc when compared with postoperative results was 96.4%(27 discs/28 discs) in the CT-discogram, 82.6%(19 discs/23 discs) in MRI and 71.4%(15 discs/21 discs) in the CT scan. Pains encountered during discography were radiating pain in 12 discs and back pain in 24 discs. CT-discography was especially helpful in 10 patients with multilevel involvement of the lumbar disc diseases to evaluate the exact location of diseased disc(s) that provoked the pain.
CONCLUSION
CT-discography is a highly accurate method in diagnosis ofthe herniated lumbar intervertebral discs and is very useful in determining the precise location related to the development of pain in such cases.