Discuss the controversy surrounding provocative discography

Discography remains a controversial test. Proponents of discography opine that disc morphology on MRI cannot be used to distinguish a painful disc from asymptomatic age-appropriate degenerative changes as justification for this test. Opponents of discography cite a high percentage of false-positive results in patients with psychological distress, chronic pain syndromes, increased somatic awareness, anular disruption, and individuals involved in litigation or workers' compensation cases. In addition, provocative discography has not been shown to improve treatment outcomes for patients with axial pain syndromes and may lead to unnecessary and ineffective spinal surgery. Use of discography to identify candidates for surgical treatment, such as a lumbar fusion, remains controversial.

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