In considering surgical options, it is important to obtaina correct and specific diagnosis sufficient to explain disabling low back pain when only common degenerativechanges are found on imaging studies. Currently availablediagnostic techniques have a number of limitations. Provocative discography (PD) is a commonly used and controversial diagnostic technique and has been used since the1940s [4]. Provocative discography involves the insertionof a needle into an intervertebral disc and the injection ofcontrast agent into the nucleus pulposus under pressure.The clinician then assesses the radiographic appearanceof the disc, and more significantly, the patient’s pain response to injection, which may be severe and similar or exactly like his or her usual symptoms. Recent articles in theliterature have suggested that the onset of pain at lower injection pressures is more characteristic of a ‘‘true-positive’’test result [5,6]