Thoracic discography.

Thoracic discography is performed much less frequently than either cervical or lumbar discography due to the relative infrequency of symptomatic thoracic disc pathology. Clinicians are less likely to ascribe thoracic pain to discogenic disease of the thoracic spine than to other more common etiologies, such as facet joint pain, muscle pain, skeletal pain or visceral pain. A comprehensive evaluation for pain includes having an index of suspicion that includes the thoracic disc as the cause of these symptoms. The purpose of thoracic discography is to identify or confirm a thoracic disc as a pain generator. The procedure itself has many similarities to the one used in the lumbar region; there are also similarities with the lumbar procedure with respect to patient selection and indications. Unintentional or inadvertent pleural puncture is a major risk of this procedure. It is a safe procedure when performed by an expert. Thoracic discography identifies the particular painful disc and provides a more complete description of thoracic disc pathology, correlated with MRI or CT findings.