The role of cervical discography in interventional pain management.

Cervical discography, cervical disc puncture with contrast dye injection under fluoroscopic guidance, is a commonly used modality in the evaluation of patients with intractable neck pain. MRI and CT scans are the initial tests in the diagnostic evaluation of symptomatic cervical discs. These provide noninvasive and accurate assessment of disc anatomy and pathologic change. Since correlation of pain with abnormalities of structural anatomy is not always reliable, direct injection of cervical discs is done to precisely localize and identify painful discs. The improvements in contrast media, imaging technique, meticulous attention to aseptic technique combined with use of antibiotics have resulted in very low rates of complications. Cervical discography is a diagnostic procedure used in complementary fashion with other imaging techniques to yield the precise disc level responsible for pain and to aid in planning treatment.