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Discography: Technique and Interpretation

Discography: Technique and Interpretation Abstract Introduction A review of the literature on x-ray visualization of the intervertebral disc has led to two conclusions. First, there is a definite need for a detailed account of the technique of disc puncture. Second, the x-ray discogram should be more clearly illustrated since its interpretation could then be more readily understood and coordinated with the clinical picture of low-back pain. The material for this report is based on experiences while working with Feffer.5,6There is a need for a more accurate method of diagnosis of intervertebral disc pathology. Although helpful, myelography can be confusing and misleading.21 Discography, devised by Lindblom,14-20 eliminates some of these difficulties and is more accurate as an indicator of intervertebral disc pathology.1-5,9,24,26 It gives information that myelography cannot,1,2,5,9 e.g., lateral disc. Furthermore, minimal routine x-ray changes are more easily evaluated and correlated with the patient's symptomatology.Discography is not the References 1. Cloward, R. B.: Anterior Herniation of a Ruptured Lumbar Intervertebral Disk: Comments on the Diagnostic Value of the Diskogram , A.M.A. Arch. Surg. 64:457-463 ( (April) ) 1952.Crossref 2. Cloward, R. B., and Buzaid, L. L.: Discography: Technique, Indications and Evaluation of the Normal and Abnormal Intervertebral Disc , Am. J. Roentgenol. 68:552-564 ( (Oct.) ) 1952. 3. Davies, J. J., and Peirce, E. C., II.: Discography in the Diagnosis of Herniation of the Lower Lumbar Intervertebral Vertebrae , Illinois M.J. 104:118-125 ( (Aug.) ) 1953. 4. Erlacher, P. R.: Nucleography , J. Bone & Joint Surg. 34-B:204-210 ( (May) ) 1952. 5. Feffer, H. L., and Rizzoli, H. U.: The Negative Myelogram and Nucleography , Postgrad. Med. 19:363-368 ( (April) ) 1956. 6. Feffer, H. L.: Treatment of Low-Back and Sciatic Pain by the Injection of Hydrocortisone into Degenerating Intervertebral Discs , J. Bone & Joint Surg. 38-A:585-592 ( (June) ) 1956. 7. Feinstein, B.; Luce, J. C., and Langton, J. N.: in Human Limbs and Their Substitutes , edited by P. E. Klopsteg and P. D. Wilson, New York, McGraw-Hill Book Co., Inc., 1954, pp. 101-120. 8. Friberg, S.: Anatomical Studies on Lumbar Disc Degeneration , Acta orthop. scandinav. 19:224, 1948. 9. Friedman, J., and Goldner, M. Z.: Discography in Evaluation of Lumbar Disk Lesions , Radiology 65:653-662 ( (Nov.) ) 1955. 10. Gardner, W. J.; Wise, R. E.; Hughes, C. R.; O'Connell, F. B., Jr., and Weiford, E. C.: X-Ray Visualization of the Intervertebral Disk, with a Consideration of the Morbidity of Disk Puncture , A.M.A. Arch. Surg. 64:355-364 ( (March) ) 1952. 11. Hirsch, C.: An Attempt to Diagnose the Level of a Disc Lesion Clinically by Disc Puncture , Acta orthop. scandinav. 18:132, 1948. 12. Inman, V. T., and Saunders, J. B. de C. M.: Referred Pain from Skeletal Structures , J. Nerv. & Ment. Dis. 99:660-667 ( (May) ) 1944. 13. Kellgren, J. H.: On the Distribution of Pain Arising from Deep Somatic Structures with Charts of Segmental Pain Areas , Clin. Sc. 4:35-46 ( (June) ) 1939. 14. Lindblom, K.: Protrusions of Disks and Nerve Compression in the Lumbar Region , Acta radiol. 25:195-212, 1944. 15. Lindblom, K.: Diagnostic Puncture of Intervertebral Disks in Sciatica , Acta orthop. scandinav. 17:231-239, 1948. 16. Lindblom, K., and Rexed, B.: Spinal Nerve Injury in Dorso-Lateral Protrusions of the Lumbar Disks , J. Neurosurg. 5:413-432 ( (Sept.) ) 1948. 17. Lindblom, K.: Technique and Results in Myelography and Disk Puncture , Acta radiol. 34:321-330 ( (Oct.-Nov.) ) 1950. 18. Lindblom, K., and Hultquist, G.: Absorption of Protruded Disc Tissue , J. Bone & Joint Surg. 32-A:557-560 ( (July) ) 1950. 19. Lindblom, K.: Technique and Results of Diagnostic Disk Puncture and Injection (Discography) in the Lumbar Region , Acta orthop. scandinav. 20:315-326, 1951. 20. Lindblom, K.: Discography of Dissecting Transosseous Ruptures of Intervertebral Disks in Lumbar Region , Acta radiol. 36:12-16 ( (July) ) 1951. 21. MacCarty, W. C., Jr., and Lane, F. W., Jr.: Pitfalls of Myelography , Radiology 65:663-670 ( (Nov.) ) 1955. 22. Pease, C. N.: Injuries to the Vertebrae and Intervertebral Disks Following Lumbar Puncture , Am. J. Dis. Child. 49:849-860, 1935. 23. Roof e, P. G.: Innervation of Annulus Fibrosus and Posterior Longitudinal Ligament: Fourth and Fifth Lumbar Level , J. Neurol. & Psychiat. 44:100-103 ( (July) ) 1940. 24. Walk, L.: Diagnostic Lumbar Disk Puncture: Clinical Review and Analysis of 67 Cases , A.M.A. Arch. Surg. 66:232-243 ( (Feb.) ) 1953. 25. Wiberg, G.: Back Pain in Relation to Nerve Supply of the Intervertebral Disc , Acta orthop. scandinav. 19:211, 1949. 26. Wise, R. E.; Gardner, W. J., and Hosier, R. B.: X-Ray Visualization of the Intervertebral Disk , New England J. Med. , 257:6-10 ( (July 4) ) 1957. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Discography: Technique and Interpretation

A.M.A. Archives Surgery , Volume 80 (4) – Apr 1, 1960

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1960.01290210048010
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Abstract

Abstract Introduction A review of the literature on x-ray visualization of the intervertebral disc has led to two conclusions. First, there is a definite need for a detailed account of the technique of disc puncture. Second, the x-ray discogram should be more clearly illustrated since its interpretation could then be more readily understood and coordinated with the clinical picture of low-back pain. The material for this report is based on experiences while working with Feffer.5,6There is a need for a more accurate method of diagnosis of intervertebral disc pathology. Although helpful, myelography can be confusing and misleading.21 Discography, devised by Lindblom,14-20 eliminates some of these difficulties and is more accurate as an indicator of intervertebral disc pathology.1-5,9,24,26 It gives information that myelography cannot,1,2,5,9 e.g., lateral disc. Furthermore, minimal routine x-ray changes are more easily evaluated and correlated with the patient's symptomatology.Discography is not the References 1. Cloward, R. B.: Anterior Herniation of a Ruptured Lumbar Intervertebral Disk: Comments on the Diagnostic Value of the Diskogram , A.M.A. Arch. Surg. 64:457-463 ( (April) ) 1952.Crossref 2. Cloward, R. B., and Buzaid, L. L.: Discography: Technique, Indications and Evaluation of the Normal and Abnormal Intervertebral Disc , Am. J. Roentgenol. 68:552-564 ( (Oct.) ) 1952. 3. Davies, J. J., and Peirce, E. C., II.: Discography in the Diagnosis of Herniation of the Lower Lumbar Intervertebral Vertebrae , Illinois M.J. 104:118-125 ( (Aug.) ) 1953. 4. Erlacher, P. R.: Nucleography , J. Bone & Joint Surg. 34-B:204-210 ( (May) ) 1952. 5. Feffer, H. L., and Rizzoli, H. U.: The Negative Myelogram and Nucleography , Postgrad. Med. 19:363-368 ( (April) ) 1956. 6. Feffer, H. L.: Treatment of Low-Back and Sciatic Pain by the Injection of Hydrocortisone into Degenerating Intervertebral Discs , J. Bone & Joint Surg. 38-A:585-592 ( (June) ) 1956. 7. Feinstein, B.; Luce, J. C., and Langton, J. N.: in Human Limbs and Their Substitutes , edited by P. E. Klopsteg and P. D. Wilson, New York, McGraw-Hill Book Co., Inc., 1954, pp. 101-120. 8. Friberg, S.: Anatomical Studies on Lumbar Disc Degeneration , Acta orthop. scandinav. 19:224, 1948. 9. Friedman, J., and Goldner, M. Z.: Discography in Evaluation of Lumbar Disk Lesions , Radiology 65:653-662 ( (Nov.) ) 1955. 10. Gardner, W. J.; Wise, R. E.; Hughes, C. R.; O'Connell, F. B., Jr., and Weiford, E. C.: X-Ray Visualization of the Intervertebral Disk, with a Consideration of the Morbidity of Disk Puncture , A.M.A. Arch. Surg. 64:355-364 ( (March) ) 1952. 11. Hirsch, C.: An Attempt to Diagnose the Level of a Disc Lesion Clinically by Disc Puncture , Acta orthop. scandinav. 18:132, 1948. 12. Inman, V. T., and Saunders, J. B. de C. M.: Referred Pain from Skeletal Structures , J. Nerv. & Ment. Dis. 99:660-667 ( (May) ) 1944. 13. Kellgren, J. H.: On the Distribution of Pain Arising from Deep Somatic Structures with Charts of Segmental Pain Areas , Clin. Sc. 4:35-46 ( (June) ) 1939. 14. Lindblom, K.: Protrusions of Disks and Nerve Compression in the Lumbar Region , Acta radiol. 25:195-212, 1944. 15. Lindblom, K.: Diagnostic Puncture of Intervertebral Disks in Sciatica , Acta orthop. scandinav. 17:231-239, 1948. 16. Lindblom, K., and Rexed, B.: Spinal Nerve Injury in Dorso-Lateral Protrusions of the Lumbar Disks , J. Neurosurg. 5:413-432 ( (Sept.) ) 1948. 17. Lindblom, K.: Technique and Results in Myelography and Disk Puncture , Acta radiol. 34:321-330 ( (Oct.-Nov.) ) 1950. 18. Lindblom, K., and Hultquist, G.: Absorption of Protruded Disc Tissue , J. Bone & Joint Surg. 32-A:557-560 ( (July) ) 1950. 19. Lindblom, K.: Technique and Results of Diagnostic Disk Puncture and Injection (Discography) in the Lumbar Region , Acta orthop. scandinav. 20:315-326, 1951. 20. Lindblom, K.: Discography of Dissecting Transosseous Ruptures of Intervertebral Disks in Lumbar Region , Acta radiol. 36:12-16 ( (July) ) 1951. 21. MacCarty, W. C., Jr., and Lane, F. W., Jr.: Pitfalls of Myelography , Radiology 65:663-670 ( (Nov.) ) 1955. 22. Pease, C. N.: Injuries to the Vertebrae and Intervertebral Disks Following Lumbar Puncture , Am. J. Dis. Child. 49:849-860, 1935. 23. Roof e, P. G.: Innervation of Annulus Fibrosus and Posterior Longitudinal Ligament: Fourth and Fifth Lumbar Level , J. Neurol. & Psychiat. 44:100-103 ( (July) ) 1940. 24. Walk, L.: Diagnostic Lumbar Disk Puncture: Clinical Review and Analysis of 67 Cases , A.M.A. Arch. Surg. 66:232-243 ( (Feb.) ) 1953. 25. Wiberg, G.: Back Pain in Relation to Nerve Supply of the Intervertebral Disc , Acta orthop. scandinav. 19:211, 1949. 26. Wise, R. E.; Gardner, W. J., and Hosier, R. B.: X-Ray Visualization of the Intervertebral Disk , New England J. Med. , 257:6-10 ( (July 4) ) 1957.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Apr 1, 1960

References