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Complications of Cervical Discography: Analysis of 4400 Diagnostic Disc Injections

Zeidman, Seth M. M.D.; Thompson, Kerry M.D.; Ducker, Thomas B. M.D.

Clinical Study

DESPITE EXTENSIVE EXPERIENCE with diagnostic cervical disc injection, the role of this procedure in the evaluation of patients with degenerative disc disease and severe neck pain remains controversial. Beyond the debate regarding its efficacy in identifying the site of cervical symptomatology and directing appropriate intervention are the potential morbidity and mortality associated with this diagnostic procedure. Discitis, subdural empyema, spinal cord injury, vascular injury, and prevertebral abscess have all been reported as complications of diagnostic cervical disc injection. Any meaningful assessment of the role of cervical discography in the evaluation of degenerative disc disease must include a determination of the risks inherent in the procedure. We retrospectively analyzed 4400 cervical disc injections in 1357 patients performed by an experienced radiologist between 1988 and 1993 to define the morbidity and mortality associated with discography. In addition, we reviewed the extant medical literature on the complications of this controversial procedure. This study demonstrates significant complications from diagnostic discography procedures occurring in less than 0.6% of the patients and 0.16% of the cervical disc injections.

Department of Neurosurgery, The Johns Hopkins University School of Medicine (SMZ, TBD), Baltimore, Maryland; Department of Radiology, Anne Arundel Medical Center (KT), Annapolis, Maryland; and Department of Neurosurgery, The University of Maryland (TBD), Baltimore, Maryland

Reprint requests: Seth M. Zeidman, M.D., Department of Neurosurgery, The Johns Hopkins Hospital, Meyer 7-113, 600 North Wolfe Street, Baltimore, MD 21287.

Received, December 12, 1994. Accepted, March 1, 1995.

Copyright © by the Congress of Neurological Surgeons