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I was all scheduled to have a dye injected into my spine to verify that my back pain is coming from a disc herniation. Then all of a sudden, some guy in California says that test could cause problems. So my surgeon says it's off for now. Where does that leave me? I want to get to the bottom of this pain and get rid of it.

You may be referring to the recent report from the Stanford Discography Project that showed some potential adverse effects of this test. It turns out that when the dye is injected into the disc, the tiny puncture wound damages the disc enough to cause future problems. Over time (seven to 10 years), the disc loses height and vitality. The risk of disc degeneration and herniation goes up. Maybe that won't matter if you end up having that disc removed anyway. But often the discography is done on two or three vertebral levels trying to find the exact location of the problem. It's possible discography could be used effectively and safely with certain subgroups of patients but that hasn't been investigated or discovered as yet. For now, it's clear that the role of discography is being questioned and some further answers are needed. The Stanford Discography Project hopes to answer some of those questions in the not-too-distant future. The fact that your surgeon is up-to-date on this information is a good sign. Previous studies questioning the use of discography have been ignored by too many people. This new evidence that discography has a potential role in future disc degeneration should be taken seriously. You may not be out of options yet. The next step is to meet with your surgeon and find out what are your diagnostic and treatment choices.

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