Cervical analgesic discography. A new test for the definitive diagnosis of the painful-disk syndrome.

The cervical discogenic (painful-disk) syndrome consists of scapular pain radiating into the head, shoulder, and upper arm, often associated with paresthesias but without neurologic deficit. Plain roentgenograms or myelograms are normal or show degenerative changes. Positive-contrast discography has been useful but is subject to a high percentage of false-positive results roentgenographically and nonspecific pain patterns clinically. Analgesic discography more precisely confirms the diagnosis and more accurately locates the pain-producing disk. Injection of a local anesthetic into a painful disk produces transient symptomatic relief and full neck mobility. Its use during a two-year period in 71 consecutive discogenic patients followed by anterior cervical fusion resulted in a 93% excellent or good recovery rate. Analgesic discography is the most effective test for diagnosis and location in the painful-disk syndrome.