Discography

A discogram is an x-ray procedure that deliberately provokes the patient’s pain symptoms in order to pinpoint its source in the intervertebral discs. The procedure is designed to create a pain “road-map,” making the discogram an excellent fusion surgery-planning tool.

Discography is reserved for patients who have not responded to medications and conservative treatments, such as bed rest, traction, or physical therapy, and for whom the possibility of lumbar (lower back) surgery is being considered. Besides studying abnormal discs, discograms can detect problems within intervertebral discs that appeared normal on the CT or MRI scan.

Procedure preparation

A technologist or nurse will contact you 24-48 hours prior to your appointment to review medications you are currently taking, especially pain medications and blood thinners, discuss known allergies and your medical history, as well as answer your questions.

Contact your doctor before you stop taking any medication.

Please bring previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs, if available.

You will need a driver for your appointment. If you are unable to drive or arrange transportation, call us for assistance.

Please notify a member of our staff if you are nursing or if there is a chance you may be pregnant.

What to expect during the procedure

You will lie on your stomach for lumbar and thoracic procedures and on your back for cervical procedures.

Using x-ray-guidance (fluoroscopy), a radiologist will place a thin needle into the center of your disc(s) thought to be causing your pain.

Contrast is then injected and x-rays are taken.

During and immediately following the procedure, you will be asked to describe what you are feeling (i.e., does it reproduce your symptoms). A discogram reveals the exact source of your disc pain by awakening the pain symptom in that disc.

When a healthy disc is injected, you will feel little or no pain. If the disc is not healthy, your pain may intensify.

As soon as that symptom has been recorded, the radiologist will put the disc to sleep with a local anesthetic (numbing medication).

You will remain awake during your procedure, which takes approximately 15-40 minutes.

In selected cases, a CT exam will follow, depending on the findings of your study and any prior imaging you may have had.

What to expect after the procedure

Some degree of discomfort during and after this procedure is expected.

Limit your “stress-bearing” or “strenuous” activities for 24 hours due to expected post-procedure discomfort.

We recommend taking the following day off of work, but the decision to return to work is at your discretion.

A prescription for post-procedural pain medication is available for patients who require it.

Potential side effects

Steroid medications may cause facial flushing, occasional low-grade fevers, hiccups, insomnia, headaches, water retention, increased appetite, increased heart rate, and abdominal cramping or bloating.

These side effects are bothersome in only about 5% of patients and commonly disappear within 1-3 days after the injection.