Imaging for provocative discography and minimally invasive percutaneous procedures for treatment of discogenic lower back pain

The imaging for diagnostic and minimally invasive therapeutic procedures for treatment of discogenic pain is comprised mostly of the fluoroscopic real-time imaging. Computed tomography is mainly used following provocative discography to assist in establishing the diagnosis. Intradiscal electrothermal annuloplasty, radiofrequency annuloplasty using DiscTrode™, or transdiscal biacuplasty all utilize fluoroscopy imaging with C-arm features to facilitate the placement of the electrodes. In this review, fluoroscopic imaging for each of these techniques when used for lower back pain, as well as suggested appropriate imaging approaches utilizing minimal radiation exposure are described.

Keywords: Provocative discography, Intradiscal biacuplasty, Discogenic pain, Degenerative disc disease, Intradiscal electrothermal therapy