Fuzzy, thanks for posting. I'm suprised to hear that that was your experience. I've had > a dozen clients go to him and have not heard any negative feedback. It's funny how experiences can be so varied.
I've had 4 discographies myself and if I was considering lumbar surgery again, unless the case is very clear cut, I'd still do it. I've been in the procedure room for > 50 discographies now and have seen a wide variety of results. I have seen may cases where the disc that looked worst was not a pain generator at all, when a disc that didn't look nearly as bad and was going to be left out of the surgery was VERY CLEARLY the main pain generator. In cases like these, discography makes all the difference in the world. (See annC's story on the GPN story pages.) I have had many experiences like that.
Discography is a double subjective test. The outcome depends upon the doctor's subjective assessment of the patient's subjective assessment of their pain. Under the best of circumstances, the usefulness of the test will vary a great deal and there are many variables. Technique is VERY importatant. The patient's anatomy and pathology is very important. Appropriate anesthesia (or lack thereof) is very important. Also, most important is the communication between the doctor and patient. Several time's I've been present when the doctor asks the patient a question, then the patient answers a different question. Neither one knew that there was a disconnect. I've seen this happen many time and it's not necessarily a language problem.
More later,
Mark
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