What is a Discogram or Discography?
A discography is a procedure that will help your doctor better see the discs in your spine and determine which disc may be causing your pain. The disc is injected with an x-ray dye to see if there is any abnormality in the disc itself. At least two of your discs will be tested so that the results can be compared. If there is a problem within the disc, this test will help your doctor determine which treatment may help you the most to reduce your pain. Discography can be helpful in those patients who have not responded to a physical therapy or who have normal or fairly normal MRI findings. In such cases, it may have some benefit in localizing a symptomatic disc as the etiology of the pain.
A positive provocative discogram must include a pain response. This includes reproduction of the patient’s symptoms when a symptomatic disc is injected. A non-painful response would also be seen when injection is done into a disc that is thought not to be painful or a “control disc”. One may also observe disc annular pathology on post discography CT scanning if this is done. Discography is most often used prior to thinking about surgical procedures for unremitting pain due to a symptomatic internal disc disruption. Some have found discography followed by CT to be a more precise technique and may delineate pathology with sensitivities similar to or better than MRI and CT/myelography. This type of test is the only quasi-objective provocative test for disc-mediated pain.
What can you expect during the procedure?
Fluoroscopy (X-Ray) and contrast dye, if you are not allergic to it, will be used to help guide the needle(s) to the correct position. If there is damage to the disc, you will feel pain when the fluid is injected. You will need to tell the doctor whether this is the same pain that you usually feel. A discogram may be painful, but it can give your doctor valuable information to help plan your treatment.
The procedure is performed under aseptic (sterile) conditions. If you would like a sedative to help you relax for the procedure, an intravenous needle will be placed by the nurses at the Pain Clinic. You can’t be totally “asleep” for this procedure. If you are receiving sedation, your vital signs will be watched with several monitors for your safety.
What can you expect after the procedure?
You will be discharged 30-60 minutes after the procedure. If sedated during your procedure, you will need someone to drive you home, as you may be drowsy from the medications. Further, you are restricted from driving any automobile or motorized/mechanized vehicle that day or from operating heavy machinery/equipment of any type that day. Even if you have not had sedation, you should not lift anything heavier than 5 pounds or do any type of strenuous work that day. It is possible for your pain to be increased for 24-48 hours after the procedure. As the medication begins to work, you hopefully will find that your pain begins to decrease. There will be a small Band-Aid over the injection site which should be removed the following morning. At that point in time, you will be able to shower.