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Diagnostic Discography

What is Discography?

 

Discography is a procedure in which an x-ray is used to view damaged areas of the spinal disc. These areas are made visible by injecting a dye into the center of the disc. The amount of pressure needed for the injection, any pain felt, and how the dye appears all are used when evaluating the patient. Discography is suggested for those considering IDET or surgery.

 

How is Discography performed?

 

The test is performed on an outpatient basis. A local anesthetic is used to numb the target area. Fluoroscopy, an imaging technique that projects an x-ray type picture onto a monitor, is used to guide the spinal needle into the suspect intervertebral disc. A radiopaque dye is then injected through the spinal needle into the nucleus (center) of the disc. Following discography, the patient should drink plenty of fluids (e.g. water, juice) to clear the dye from the body.

 

How does this test help the doctor diagnose my condition?

 

The act of injecting the dye into the disc increases the pressure within the disc. This pressurization is the most important part of the study and you must concentrate on what you are feeling. There are essentially three choices:

1. You feel nothing
   
2. You feel pressure
   
3. You feel pain

If you feel pain from the injection, the pain is either:

• Familiar pain, which translates into "ouch, that's my pain!"
• Unfamiliar pain, which belongs to someone else or translates into "ouch, I've never felt that pain before."
• After each level is pressurized, pictures are taken with the fluoroscopic unit and the needles are removed. Usually, a post-discogram CT is obtained to document the internal architecture of the disc. And that's it!
  

How many discs will be injected?

 

Based on your symptoms and your MRI, we will identify which discs we suspect are causing your pain. These discs will be injected. In addition, a normal disc is injected to serve as a reference point.

 

How long does the procedure take?

 

The procedure usually takes less than an hour to perform.

 

Will I be sore after the procedure?

 

You'll have soreness from the needle punctures that lasts several days. You may use acetaminophen, ibuprofen or apply an ice pack for a few minutes to ease the soreness.

 

Who should not have this procedure?

 

There are a number of factors that indicate you should not have a discogram. If you have an allergy to dye, an active infection or a local infection at the site to be injected, you should discuss it with your health care provider. Psychological factors may be taken into consideration as well.