When you suffer from back pain, it’s important to understand the symptoms, risks and causes, diagnosis, and treatment options for a variety of spine disorders and diseases like degenerative disc disease. This article will provide you with some insights into how annulograms and other imaging options work to diagnose degenerative disc disease.
X-Ray Imaging
Having an X-Ray is a well-known diagnosis method that you are probably familiar with and allows your physician to see narrowed spine channels, bone fractures, bone spurs or osteoarthritis. However, an X-ray does not show soft tissue, and in addition, it can not pinpoint the source of the pain or reveal disc tears. If you have an X-Ray that indicates a spine disorder, like degenerative disc disease, you will need more testing for diagnosis.5
Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) Scan
When it comes to being diagnosed for spinal disorders and diseases like degenerative disc disease, most people are familiar with having an MRI or CT Scan. An MRI can help detect disc and joint abnormalities, such as bulging discs and degenerative discs.4 A CT Scan can identify muscle and bone disorders as well as detect and monitor diseases.2 However, like an X-Ray, an MRI or a CT Scan cannot always pinpoint your source of pain or disc tears.
Degenerative Disc Disease Diagnosis by Discography Testing
Another option for diagnosing your degenerative disc disease pain is Discography, which is more reliable than an MRI in pinpointing the source of pain. The testing process of discography involves x-ray contrast being injected into the center of the discs followed by pressurization of the discs to replicate the symptoms of disc tears. The results of the x-ray image are referred to as discography and unlike an X-Ray, MRI, or CT scan it can find the source of the pain to aid in long term relief from degenerative disc disease. However, there is a concern by scientific critics that discography doesn’t produce a natural situation, so the results may be irrelevant.3
Stanford University also performed a 10-year study on patients who underwent discography versus a control group that did not and compared disc degeneration. The study showed that those who had discography had accelerated disc degeneration, significant disc height loss and new disc herniations in comparison to the control group.1
Annulograms
A newer, more precise diagnostic test in which a small volume of x-ray contrast dye is injected into the outer portion of the disc, the annulus fibrosus, to identify annular tears. It targets annular tears because all sensory nerves reside in the annulus fibrosus and all disc pathology, including disc degeneration, herniation, and bulge, are associated with annular tears.
Annulograms are designed to visualize all tears in the region of symptoms, and not meant to provoke pain. In comparison, the discogram test is meant to provoke pain to precisely identify causative tears in offending discs.
Published research shows that using positive annulograms to identify discs that were subsequently treated provided patient relief, showing that annulograms have diagnostic value.
If you do suffer from pain in your spine and the surrounding areas that may be caused by degenerative disc disease, you should visit your physician to get the appropriate diagnosis and treatment early on to prevent your injury from worsening.
- Carragee, E. J., Don, A. S., Hurwitz, E. L., Cuellar, J. M., Carrino, J. A., & Herzog, R. (2009, October 1). 2009 ISSLS Prize Winner: Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19755936
- CT scan. (2020, February 28). Retrieved from https://www.mayoclinic.org/tests-procedures/ct-scan/about/pac-20393675
- Discogram. (2020, February 26). Retrieved from https://www.mayoclinic.org/tests-procedures/discogram/about/pac-20393818
- MRI. (2019, August 3). Retrieved from https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768
- X-ray. (2020, February 5). Retrieved from https://www.mayoclinic.org/tests-procedures/x-ray/about/pac-20395303
