A discography, also known as a discogram, is a diagnostic test performed to determine whether back pain is a result of certain spinal disc abnormalities.
The intervertebral discs are spongy pads of cartilage that offer cushioning and allow for flexibility between the vertebrae of the spine. A herniated disc, also called a ruptured or slipped disc, is a common condition that may occur as a result of gradual wear and tear on the disc or from an injury to the spine that cracks or tears the disc and causes it to bulge or break open. This can produce pain, numbness and weakness in the back or legs as the disc presses on the nearby nerve roots. It is important to determine which disc or discs are damaged in order to ensure that the patient will receive the appropriate form of treatment.
A discography test is performed by injecting a special dye into the patient’s spinal discs and using imaging technology to view the area in greater detail. Due to its invasive nature, a discography is only considered for patients with persistent back pain that remains unresponsive to treatment. A discography may also be performed on candidates for spinal fusion surgery to identify the damaged discs that will need to be removed during surgery.
The Discography Procedure
Before undergoing a discography, Dr. Lipani will provide specific instructions regarding the cessation of eating, drinking and taking medications. He will also address any questions or concerns the patient may have regarding the procedure.
A discography is usually performed as an outpatient procedure that lasts for approximately 30 to 45 minutes. Before the procedure begins, the patient will be asked to change into a dressing gown. During the discography, the patient will be lying down on his or her side on a special table. After the patient is properly positioned, the injection site on the back is sterilized. In some cases, an additional anesthetic injection is administered to minimize pain during the procedure and a sedative is provided to help the patient relax.
With the help of fluoroscopy guidance, a needle is then inserted through the skin and into each disc to be examined. Next, a contrast dye is injected into each disc, and then the needle is removed. After each disc to be examined is injected with the contrast dye, an X-ray or CT scan is performed to see if the dye has traveled throughout the discs. The contrast dye will remain in the center of a healthy disc and spread outwards if a disc is damaged. In a disrupted disc, the injection will also produce the same type of pain that has been a persistent symptom for the patient. The patient will be asked to identify this pain when it occurs.
Immediately after the discography, the patient will remain under observation for approximately one hour. While it is normal to experience some discomfort at the injection site for a few hours following the discography procedure, patients should contact the doctor right away if they begin to experience any severe pain.
After the discography has been completed, a radiologist will review and interpret the results, and send them to the physician. The doctor and patient will then discuss the results and determine an appropriate treatment plan to resolve the back pain.
While a discography is generally considered a safe procedure, it does carry a slight risk of complications. If a disc is damaged, there will be some pain during the procedure, although this is usually tolerable. Complications, although rare, may include headache, nausea, allergic reaction to the contrast dye, infection of the area between the discs, temporary weakness or numbness and injury to the blood vessels in the area surrounding the spine. These risks can be further minimized by choosing a qualified medical professional to perform the discography procedure.