Diagnostic value of CT discography in unclear radiculopathy

A clinically evident radiculopathy without correlation in the imaging studies represents a serious problem regarding the indication, planning and execution of an operative procedure for its treatment. Both the diagnosis and treatment of such cases are deemed to be difficult without clear morphological correlation. Moreover, the surgeon lacks an important basis for the adequate planning and above all the justification of surgical treatment. Although discography with post-discographic computer tomography (CT discography) is still controversially discussed as an invasive diagnostic measure, the literature shows that this method is not only useful but also indispensable in certain cases. Based on these findings and our own empirical data, we recommend CT discography to be considered for imaging in patients suffering from lumbar radiculopathy with equivocal or insufficient MRI findings. The technique allows an accurate diagnosis and precise planning of a targeted surgical intervention such as endoscopic sequestrotomy or decompression. © Georg Thieme Verlag KG Stuttgart · New York.