Provocative diskography: safety and predictive value in the outcome of spinal fusion or XXXX intervention for chronic @entity1643 .

@entity1 @entity1643 @entity1512 @entity1797 @entity615 @entity158 @entity528
There is still no clear definition of diskogenic @entity1643 and no consensus on a generally agreed test, such as provocative diskography (PD), to diagnose painful @entity1797 , and probably more importantly, to predict the outcome of therapy intended to reduce @entity158 that is presumed to be diskogenic in nature. Nevertheless, PD is the most specific procedure to diagnose diskogenic @entity1643 . Its accuracy, however, is rather low or at best unknown. Although rare, the most prevalent complication, postdiskography @entity1512 , can be devastating for the individual @entity1 , so all measures, like strict sterile conditions and antibiotic prophylaxis, should be taken to avoid this complication. It is advised to perform the procedure in a pressure-controlled way with a constant low flow, and optionally computed tomography imaging. PD should not be performed in morphologically normal disks. A standardized execution of the test should be established in order to perform high-quality studies to determine its accuracy to lead to meaningful interventions, and find best practices for diagnosis and @entity615 . Possibly, PD may have detrimental effects on the disk, causing @entity528 , although it is unknown whether this will be related to clinical symptoms. Especially with these possible adverse side effects in mind, the risk-benefit ratio with the lack of clear benefits from treatments provided, and possible complications of disk puncture, the rationale for PD is questionable, which should be stressed to @entity1 in the process of shared decision making. Diskography as a stand-alone test is not recommended in clinical decision making for @entity1 with chronic @entity1643 .
