Possible predictive markers to make a decision for surgical intervention in discography

Aim: In this retrospective study, the diagnostic and therapeutic events of discography and disc-blockage (discoblock) were investigated in patients whose clinical symptoms could not be explained by CT and/or MR images. Material and Methods: The study included patients applied with discography between August 2014 and October 2016. Patient data were recorded, consisting of age, gender, pre-procedure Visual Analogue Scale (VAS) score (PRE-VAS), post-procedure VAS score (POST-VAS), and pre-procedure “Japanese Orthopedic Association” (JOA) score (PRE-JOA), post-procedure JOA score (POST-JOA), long-term follow-up VAS score (FOLLOW-VAS) and JOA score (FOLLOW-JOA), level of herniated disc in the spinal column (L1-2, L2-3, L3-4, L4-5, L5-S1), size of herniated disc ("bulging", "protrusion", "extrusion") and localization of the herniated disc in the spinal canal (median or foraminal). Results: Evaluation was made of a total of 22 patients (11 females, 11 males) aged 32 - 60 years. Discectomy after discography and/or discoblock was applied to 12 patients. The PRE-VAS scores of patients who underwent discectomy were higher than those of patients who did not undergo surgery, and the scores were lower in the postoperative period than those of the unoperated group. The long term (6 months) follow-up results indicated that patients with discectomy and those without surgery had similar levels of pain. The JOA scores of patients with discectomy were higher than those of patients without surgery. Conclusion: At the end of this study, it was thought that discography and discoblock procedure could be an adjunctive test for decision-making in respect of surgery for patients who were not diagnosed using radiological views and clinical symptoms. Furthermore, it was considered that the VAS score applied before and after discography may identify the patients who will be applied with discectomy