Disc space injection with marcaine as a method to evaluate painful nonunion of an interbody fusion device: a case report

Background contextDiscography has been successfully used to distinguish painful from asymptomatic intervertebral discs.PurposeTo report a case of chronic back pain following two-level interbody and posterolateral fusion in the lumbar spine that was evaluated with marcaine injection into the disc space.Study designCase report.MethodsA patient with chronic back pain after a two-level anteroposterior lumbar fusion was evaluated. A complete description of the history, physical examination, and relevant radiographic images along with a brief review of the pertinent literature are included.ResultsInjection of marcaine into the area of previous interbody fusion resolved the painful symptoms, and surgery confirmed the nonunion.ConclusionsIn cases of interbody lumbar fusion with questionable solidity, marcain injection within the disc space can help in the assessment of the source of pain even at the intervertebral spaces with cages.