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Discogram

Procedure Benefits:

  • Interventional diagnostic test that allows physicians to view and assess the internal structure of a disc in order to determine the exact source of back pain
  • Assists physician in future surgical planning
  • Performed in office
  • Patient goes home within 30 minutes

Overview

This diagnostic procedure, also called discogram, is used to determine whether back pain is caused by one or more spinal discs. The procedure involves pressurizing suspect discs with an injection of sterile liquid to induce pain. Discography helps the specialist plan a course of treatment.

About the Procedure

discogram

IV Inserted
In preparation for the procedure, the patient lies on the side or stomach on a table equipped with a type of x-ray unit called a fluoroscope.
Medication is administered through an intravenous (IV) line to relax the patient. It is important for the patient to be awake enough to tell the physician what he or she is feeling.
A local anesthetic is used to numb the skin and all the tissue down to the disc area.

Guide Needles Inserted
A guide needle is inserted through the anesthetized track to the outer edge of the disc. The physician uses the fluoroscope to identify the target disc. A smaller needle is inserted through the guide needle into the center of the disc. This may be repeated for several discs.

Discs Tested
Once all the needles are placed, the discs are pressurized one at a time with injections of contrast dye. With each injection, the patient may feel either pressure or pain. If the patient feels pain, the physician will ask the patient to compare it to the pain the patient has been experiencing. If the pain is the same, this may indicate a diseased disc. After each disc is tested, images are taken with the fluoroscopic unit.

Needles Removed
The needles are removed. The patient may be taken for a CT scan to obtain additional images of the inside of the discs.

End of Procedure
Discography usually takes less than an hour to perform. The procedure may cause soreness for a few days. The patient is usually advised to take acetaminophen or ibuprofen and to ice the affected area for several minutes each day until the soreness subsides.

After the Procedure

After the procedure, you will be transferred to a recovery area where a specially trained nurse will monitor your recovery and pain levels. Generally, patients are discharged within 15 minutes.
Your doctor will have you schedule a follow-up visit and explain limitations, if any, on your physical activity. After treatment with, mobility is often quickly improved. Most patients are very satisfied with the procedure and are able to gradually resume activity.

As with any procedure, there are potential risks. Although discography is designed to minimize these risks as much as possible, there is a chance that complications could occur. Be sure to discuss the possible risks with your doctor. Also, please note that not all patients are candidates for discography. For more information on specific risks, please speak with your physician.

Frequently Asked Questions


What should I do to prepare for the discogram?
Do not take solids by mouth after midnight before the procedure. Fluids and medications are all right to have on the morning of the examination. If the procedure is scheduled for the end of the day, it is okay to have breakfast. You will undergo an evaluation by the anesthesiologist for what is known as conscious sedation. Please follow the instructions of the anesthesiologist. On the day of the procedure you will be seen by a nurse, who will take your vital signs, start your intravenous line (if necessary), and answer any questions you may have.
Will I need other tests?
A discogram is often used in conjunction with other examinations such as routine radiographs, an MRI examination or a myelogram and CT examination.
What are the alternatives?
Other tests such as routine radiographs, myelogram, CT or MRI can give information about disc degeneration or herniations. However, these tests cannot always specifically localize the level producing your symptoms.
What can I expect after the procedure?
Soreness at the injection site(s) may occur and usually lasts hours or a few days. After the procedure you can expect your usual spine related symptoms.