UNDERSTANDING BACK TROUBLE: FURTHER TESTS-DISCOGRAPHY

April 1, 2009 in Healthy bones Osteoporosis Rheumatic | Tags: Healthy bones

This is a similar procedure, used for making discs visible on X-rays, and may show up prolapse bulges that do not show up on myelograms. The contrast medium is injected into the centre of discs, usually the three lowest lumbar discs. Only a small quantity of contrast medium is used, and the patient does not have to be tipped about. In a healthy disc, the medium stays discretely in the middle, but in a degenerated one it spreads out and may show the extent and direction of any prolapse. The X-ray specialist performing this test will ask if the pain is reproduced by the injection into the disc.

There are some other radiological investigations for someone with severe symptoms or repeated attacks (these investigations are the exception rather than the rule for uncomplicated cases of back and sciatic pain). For example, the nerve root itself can be injected outside the spinal canal – extraspinal radiculography. The epidural space can be injected via the gap between the bones of the sacrum and coccyx to show the space in the spinal canal surrounding the dural tube – epidurography. Alternatively, the medium can be injected direct into the bone of the spinous process and then drains into the veins of the epidural space – epidural venography. More commonly, this is done by inserting a catheter in the femoral vein in the groin and then injecting the lumbar veins – ascending lumbar venography. In stereoradiography,

X-rays are taken to give a three-dimensional effect.

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