Percutaneous procedures for the diagnosis and treatment of lower back pain: diskography, facet-joint injection, and epidural injection.

This review discusses the indications, techniques, complications, and results of three percutaneous procedures used to evaluate and treat lower back pain: diskography, facet-joint injection, and epidural injection. Diskography, performed by injection of contrast medium into the nucleus pulposus, is a technique used to determine the cause of lower back pain in patients in whom findings on other imaging studies are normal or conflicting. Injection of steroids and anesthetic into the facet joints of the lumbar spine is useful to diagnose or treat patients with facet syndrome (back pain caused by abnormalities of the facet joints). Injection of steroids and anesthetic agents into the epidural space provides short-term relief, and can sometimes provide permanent relief, of lower back pain.