Hi Charles -
Thanks so much for your note. You're right in that it does seem to make sense in my case to try to identify the pain generator and location in order to help me decide (in particular foraminotomy vs. discectomy). But the docs that I've talked to have not recommended discogram / discography.
Apparently, although the info provided can be useful, there's been quite a controversy over the last few years about its real predictive value and more importantly whether it can cause damage to the discs that are being tested.
Here's a 2009 report on a clinical study comparing effects by one of its now-influential critics (Dr. Caragee):
http://www.medscape.com/viewarticle/710269
This was also discussed at the 2010 Spine Arthroplasty Society (SAS) meeting that Harrison just posted a great summary of (see page 29):
http://www.adrsupport.org/forums/f51...members-10703/
As noted a speaker called the last 10 years "the decade of Carragee" for his numerous articles showing that discography was unreliable and caused harm.
However, this led me to a follow-on discussion at SAS of a new diagnostic technique called Magnetic Resonance Spectroscopy ("MRS") that apparently has even greater sensitivity and specificity (reported on the same page noted above).
I'm meeting with Carl Lauryssen in LA tomorrow and will plan to ask him about it ...
Best to you,
Tyler
Quote:
Originally Posted by CharlesinCharge
Tyler,
Everyone is correct in that a discectomy or foraminotomy will correct radiating arm pain (which comes from the nerves being pinched) but probably will not correct neck pain if that is coming from the discs themselves. The best way to find out may be a discogram, where they inject dye into the discs and pressurize them to see if that replicates your neck pain. If it does, that indicates that the discs are the cause of the pain and not the nerves. In addition, they take a CT scan after the procedure (while the dye is still in the discs) and that allows them to better visualize the discs---if they are leaking dye that suggests they are degenerated and probably need to be replaced.
Most surgeons will not do an ADR or fusion surgery without doing a discogram first, to verify the source of the pain. It seems to me that this would allow you to find out if your neck pain was from your nerves being impinged or from the discs being degenerated.
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