Dallas discogram description: a new classification of CT/discography in low-back disorders

A new classification method for CT/discography was developed. The Dallas discogram description (DDD) related five separate categories of information. Degeneration and annular disruption were regarded as separate phenomena. Additionally, provoked pain response, contrast volume, and miscellaneous information were recorded. Discogram findings of 59 patients with low-back and/or leg pain were graded according to the new method and compared with standard methods using routine anteroposterior and lateral discographic images. Findings from routine discography and CT/discography were graded and correlated with myelographic and plain computerized axial tomography (CAT) scans. This study demonstrated that the contrast-enhanced axial view provided by CT/discography served as a useful projection for demonstrating disc pathology. CT/discography analyzed according to DDD offered a more sensitive discriminator of disc degeneration from annular disruption (disc protrusion/leaking). This evaluation can be recommended as the procedure of choice when revision of spine surgery is considered or when there is an equivocal or negative correlation between clinical information and myelography or CAT scan.