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A couple of questions


Q:
Age: 30   Sex: F   Concern: Chronic pain  

Can a discogram under sedation (150mcg fentanyl, Versad) cause a false negative? If so how can it do that? Would I have to have another to prove if the first one is valid? Do you recommend an implanted pain pump for long term chronic pain and why whichever what you answer. Do you know where I can find a Dr. in Washington state who does that procedure? thank you in advance. Allhands

-- Allhands


A:
False negative means that you didn't feel any pain during the discogram and you doctors really believe that your disc should be painful.

False negative is usually a good thing. It is the false positive that concerns us. False positive means that you have pain during the procedure where pain shouldn't be there. Patients end up with surgery and still have pain.

Be happy that you are false negative. Yes 150 mcg of Fentanyl is a lot and certainly can mask your pain. You can certainly have another discogram. That is the problem with discogram: the data can be interpreted in so many ways and it is really crucial that the doctor who does the discogram is impartial and knows what he/she is doing.

-- Sherman Nam Tran, M. D.

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