Diagnosis
A discography (discogram) is a diagnostic procedure used to assess whether damage or disease of an individual’s intervertebral disks are the source of pain. Intervertebral disks are part of each of the joints between each of the vertebrae in the spine. They are flat disks with an outer, fibrous layer and an inner gel-like layer that provide cushioning to the spine and allow it to move correctly. When an intervertebral disk is damaged or diseased, it may cause pain.
In order to identify whether it is the intervertebral disk(s) causing pain, a dye is injected into the disk(s). The doctor views on fluoroscopy (real-time x-ray) whether the dye leaks out of the disk. The doctor also requests that the patient indicates whether pain is felt due to the pressure of the dye.
Commonly used to diagnose:
- Annular tear
- Herniated disk
- Bulging disk
- Extruded disk
Procedure
When you come in for the procedure, you will have the opportunity to speak with a clinical staff member in order to have any questions answered, and you will sign a consent form. In the procedure room, you will lie on the treatment table, and the area on your body to undergo the treatment will be sterilized. A radiology tech will be present to guide the fluoroscope (x-ray machine) that your doctor will be using to visualize the needle and the intervertebral disks. You will be given a local anesthetic to decrease the pain of the procedure. The needle will be inserted in to your back, and dye will be injected into the intervertebral disks. The doctor may inject more than one disk, and may ask you to rate and describe your pain after each injection. Any pain caused by the injection should be temporary.
The entire procedure usually takes about 30 to 45 minutes. When it is finished, the needle is removed and the site is covered by a sterile bandage. Following the procedure, you will be able to rest in a recovery area. You will be provided with discharge instructions. You will need to have a responsible adult with you to drive you home. The doctor may order a CT scan for after the procedure in order to further visualize the disks.
Recovery and Benefit
The pain of the procedure should be temporary, but in some cases it can last for several hours. You may also experience muscle pain due to the needles passing through. You may call Louisiana Pain Specialists if you have any concerns during your recovery from the procedure. You may use pain medicines, ice, and rest to reduce your pain.
As a diagnostic procedure, discography can help rule out or diagnose certain conditions. This is beneficial, as the doctor is then more likely to be able to treat the specific cause of the pain. Discography is better than MRI for indicating whether intervertebral disks are the source of pain.