Discography's role in low back pain management.

SUMMARY Lumbar provocation discography is a commonly used diagnostic procedure utilized to determine the presence or absence of discogenic pain at a specific spinal segment. Although multidisciplinary societies have recognized discography as the primary criterion for identifying discogenic pain, the test remains controversial. Skeptics argue against its sensitivity and specificity, and suggest that it's risks outweigh any potential benefits. However, when properly performed and interpreted, discography is an invaluable tool. Together with a patient's history, physical examination and radiological studies, discography will safely identify both symptomatic and asymptomatic discs to provide confirmatory evidence that a particular disc is the source of the patient's pain. Since information from this study may be used to plan for percutaneous or open surgical procedures, accurate and precise interpretation of the results is vital.