Cervical analgesic discography. A new test for the definitive diagnosis of the painful-disk syndrome
D. A. Roth
The cervical discogenic (painful-disk) syndrome consists of scapular pain
radiating into the head, shoulder, and upper arm, often associated with
paresthesias but without neurologic deficit. Plain roentgenograms or
myelograms are normal or show degenerative changes. Positive-contrast
discography has been useful but is subject to a high percentage of
false-positive results roentgenographically and nonspecific pain patterns
clinically. Analgesic discography more precisely confirms the diagnosis and
more accurately locates the pain-producing disk. Injection of a local
anesthetic into a painful disk produces transient symptomatic relief and
full neck mobility. Its use during a two-year period in 71 consecutive
discogenic patients followed by anterior cervical fusion resulted in a 93%
excellent or good recovery rate. Analgesic discography is the most
effective test for diagnosis and location in the painful-disk syndrome.
