CT guided method for access to extremely difficult disc spaces without bony penetration or local anesthesia deeper than skin

Gaining needle access to the intervertebral discs for discography has been performed with fluoroscopic guidance but can be challenging when sedation cannot be used. Avoidance of the exiting L5 nerve roots is particularly challenging when the disc space is severely narrowed with overhanging endplates or osteophytes. We describe our experience on 28 discs in 10 consecutive patients referred for presurgical evaluation using low-dose computed tomography oblique axial and sagittal reformats aligned to the needle for guidance into the disc.