Discography
Discography uses imaging guidance (either X-ray or CT) to inject a contrast liquid, or dye, into the center of one or more spinal discs to help identify the source of back pain. The procedure is also used to help guide the treatment of abnormal intervertebral discs, which are sponge-like cushions located between the vertebrae of the spine.
A discogram is typically done after conservative treatment, such as medication or physical therapy, over the course of four to six months fails to alleviate back pain. The results of a discogram are usually reviewed alongside other tests to create a comprehensive treatment plan.
Benefits of Discography
The benefits of a discogram include:
- No radiation in the body after an X-ray exam
- Painless, noninvasive, and accurate
- Detailed imaging of both bone, soft tissue, and blood vessels provided by a CT scan
- Diagnostic capability
Risks of Discography
If the procedure uses a contrast material, there is a minimal risk of allergic reaction. Excessive scanning increases the risk of cancer, though the benefits of an accurate diagnosis are greater than the risk.
Bleeding
Nerve damage
Temporary numbness or weakness
Injury to the blood vessels or nerves in and around the spine
Paralysis
How to Prepare for a Discogram
Prior to the procedure, patients may need to undergo a blood test to check their kidney function and to ensure normal blood clotting. It’s important to:
Inform the doctor of current medications and herbal supplements.
List any allergies, especially to local anesthetic, general anesthesia, or contrast materials.
Stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and blood thinners before the procedure.
Inform the doctor of recent illnesses or other medical conditions.
Before the procedure, patients will need to avoid eating or drinking anything after midnight.
Patients should plan to have someone drive them home after the procedure. Women should tell their doctor and technologist if they are pregnant. Exposing the fetus to radiation could cause serious harm and the procedure should be rescheduled.
Patients should also bring recent relevant imaging exams (e.g., MRI of lumbar spine) with them on the day of the procedure.
What to Expect During The Procedure
The patient will be positioned on the examining table on their side, rolled forward slightly. Pillows will be used to keep the patient comfortable and in position. The IV insertion area will be shaved, sterilized, and covered with a surgical drape. The doctor will then numb the area with a local anesthetic and use fluoroscopy to insert a needle through the skin and into the center of the disc being examined.
Once the needle has been inserted, a contrast material will be injected and the needle will be removed. Throughout the procedure, the patient will be asked to describe the location, distribution, and severity of their pain. The process will be repeated for additional discs, and the patient will not know which disc is being injected to ensure the test is objective.
At the end of the procedure, the doctor will cover the opening in the skin with a bandage and remove the IV line.
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