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Spinal Probing: A New Diagnostic Technique for Back Pain

Lower back pain is a major health and economic issue. Diagnosis and treatment of lower back pain can be difficult. With the application of modern diagnostic tools such as CT scans, MRI, myelography, nerve electric diagnostic tests and spinal probing, the accuracy for lower back pain diagnosis has improved greatly. However, it is a common belief that 80% of the lower back pain sufferers still are misdiagnosed. Inaccurate diagnosis of the sources of pain is a key cause of treatment failure.

While discography is effective for the diagnosis of pain originating in the spinal disc, it is ineffective for diagnosis of pain from other sources. It has been found that many pain generators are located in the intervertebral foramen, such as bone spurs (osteophytes), scar tissues, inflamed tissues, and facet joint hypertrophy. Traditional imaging studies such as CT, MRI, and myelography are not very effective either in identifying pain generators located in the foraminal area. With the use of a spinal probe, however, diagnosis of pain in the foraminal area is becoming much easier.

How Is Spinal Probing Done?

During a spinal probing test, the patient is under light sedation. Under fluoroscopic guidance, the physician introduces a cannula (tube) into the target foraminal entrance. A blunt spinal probe (explorative medical device) is inserted through the cannula to reproduce pain by gentle probing. During the procedure, the cannula is repositioned to different locations but it always remains in the foraminal entrance. The foraminal contents, anterior facet margins, and posterior disc annular tissues are all probed (explored). During a spinal probing test, the patient is awake and is able to report his or her pain response. Each pain generator (source of pain) identified and the patient’s response to the probing is recorded.

Patients who have been benefited from this pioneering test include those with:

  • Severe degenerative diseases
  • Spinal stenosis
  • Foraminal stenosis
  • Slippage of vertebrae
  • Disc herniations
  • Failed back surgery syndrome

What Are the Risks of This Procedure?

The risk and complications of spinal probing may include infections, bleeding, spinal nerve injury, and spinal cord injury.