The role of myelography and discography in low back pain.
Occupational safety and health symposia 1977. Cincinnati, OH: U.S. Department of Health, Education, and Welfare, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHEW (NIOSH) Publication No. 78-169, 1978 Jun; :37-40
The role of myelography and discography in evaluating low back pain was discussed. Myelography was considered. The purpose of a myelogram was to indicate the presence of a space occupying lesion in the spinal cord which may affect the dural sac. It was noted that a myelogram should be not done just to confirm or refute a diagnosis of a ruptured lumbar disc. It should be considered only after conservative measures have failed and surgery is being considered. The limitations of myelography were discussed. A properly performed myelogram had an accuracy of 90 to 95 percent; however, even with well performed myelograms, false positives and false negatives could occur. The technique for properly performing a myelogram was discussed. Discography was considered. The purposes, efficacy, and diagnostic potential of a discogram were discussed. Discography could define a normal nucleus pulposus and, by visualizing deviations from the normal, indicate degeneration. It was noted that even though both discography and myelography can reveal lumbar disc degeneration, the techniques may not determine which disc is responsible for the patient's symptoms. Discography was considered to be the most valuable when it shows a normal nuclear outline, thereby avoiding an unnecessary exploratory laminotomy.
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