| PREOPERATIVE DIAGNOSIS: | |
| Low back pain. | |
| POSTOPERATIVE DIAGNOSIS: | |
| Low back pain. | |
| PROCEDURE PERFORMED: | |
| 1. Lumbar discogram L2-3. | |
| 2. Lumbar discogram L3-4. | |
| 3. Lumbar discogram L4-5. | |
| 4. Lumbar discogram L5-S1. | |
| ANESTHESIA: | |
| IV sedation. | |
| PROCEDURE IN DETAIL: | |
| The patient was brought to the Radiology Suite and placed prone onto a radiolucent table. The C-arm was brought into the operative field and AP | |
| left right oblique and lateral fluoroscopic images of the L1-2 through L5-S1 levels were obtained. We then proceeded to prepare the low back with a Betadine solution and draped sterile. Using an oblique approach to the spine, the L5-S1 level was addressed using an oblique projection angled C-arm in order to allow for perpendicular penetration of the disc space. A metallic marker was then placed laterally and a needle entrance point was determined. A skin wheal was raised with 1% Xylocaine and an #18-gauge needle was advanced up to the level of the disc space using AP | |
| oblique and lateral fluoroscopic projections. A second needle, #22-gauge 6-inch needle was then introduced into the disc space and with AP and lateral fluoroscopic projections, was placed into the center of the nucleus. We then proceeded to perform a similar placement of needles at the L4-5, L3-4 and L2-3 levels. | |
| A solution of Isovue 300 with 1 gm of Ancef was then drawn into a 10 cc syringe and without informing the patient of our injecting, we then proceeded to inject the disc spaces sequentially. |