PubMed · 1730210
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H J Brambs, C D Claussen. 1992-01-17. [Thoracic fluoroscopy].. https://pubmed.ncbi.nlm.nih.gov/1730210/
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Discography is a diagnostic tool that has been used for many years. Although controversial, it provides a physiologic test for evaluation of a disc with a volumetric, manometric, radiographic, and pain-provocative challenge. Although it has a controversial past, when the anatomy and pathophysiology are considered particularly in relation to intradiscal pressure and applied loads (that correlate with daily activities of the patient), the interpretation of the results of discography become more objective and reproducible. As with any procedure, indications for patient selection are an important step in successful outcomes. The equipment and technique used for performing discography using a manometry system are described in this article, as are a review of complications and outcomes. Discography is a safe, accurate, reproducible, objective diagnostic tool when tested for volume, pressure, fluoroscopic changes, and pain provocation.
The modern day treatment of UPJO with retrograde endopyelotomy continues to evolve as experience and knowledge progress. Use of the straight lateral incision and selective use of spiral CT angiogram has refined treatment decisions with retrograde endopyelotomy further. The authors' decision-oriented approach offers guidelines for the practicing urologist. Ultimately, it is up to the urologist and the patient to select the best approach for each clinical scenario.
Radiation is used during orthopaedic surgery in more than 15 million studies performed yearly. The biologic effects of radiation have been shown to inhibit mitosis by producing irrepairable deoxyribonucleic acid double strand breaks or create structural changes by damaging the nucleus, thereby producing potential genetic transmissions. Although human cells are thought to be resistant to malignant change and no studies have shown toxic effects resulting from long-term exposure to low-dose radiation, risks still are assumed. To decrease all risks, radiographic units should undergo periodic calibration, surgeons should wear protective devices, increase their working distance from the x-ray beam, and limit their duration of radiation exposure by making certain that they follow the guidelines set forth by the National Council for Radiation Protection and Measurement.