Lumbar discography.

Lumbar discography has been suggested as a means of testing the lumbar disc as a source of back pain. While some clinicians believe that discography helps to identify conditions such as internal disc disruption, and to verify painful disc levels in anticipation of surgery, others find the test unproven and of questionable benefit. While the existence of internal disc disruption is itself hotly debated, Dr. Bogduk and Dr. Modic have focused on fundamental issues in formulating their opinions on the use of this modality. While both agree that prospective, controlled clinical trials are needed, Dr. Bogduk feels that the usefulness of discography has been shown and that the test provides valuable information to the clinician and the patient. Dr. Modic feels strongly that the test has no proven efficacy in improving patient outcomes, and feels, in fact, that it leads to inappropriate surgery.