Discography is a highly refined diagnostic test used to determine if there is one or more than one disc producing pain. It is a test to help your surgeon, or pain physician, choose options for further treatment.The discs of the spine may develop tears in the outside lining that holds the spongy, shock absorber part of the disc inside. The disc may then become painful due to nerves that grow into the disc where there should be none. People suffering from this condition may experience severe back pain when they move due to these new nerves being compressed. These tears in the disc (called annular tears) may be present due to disc degeneration or trauma.
Introduction (conditions it treats):
Discography, also known as a discogram or disc stimulation, or more properly “provocation discography” according to ISIS, involves x-ray guided (fluoroscopic) placement of several needles into the discs of the spine. Most times, the patient will receive mild sedation prior to needle placement, then after needle placement is complete, each disc is sequentially injected with iodine containing contrast under fluoroscope x-ray views. The contrast pattern is also evaluated from the xray images, but more importantly, the patient is questioned about the location, severity, and character of pain produced during the injection compared to the normal every day pain experienced. Normal discs do not hurt significantly during the injection. Since not all annular tears seen on MRI cause pain, discography is the only way to determine pain producing discs. After the injection and testing is complete, the needles are removed. In positive cases a CT scan will be performed shortly after the discography if needed.
What to do before procedure:
If any sedatives are to be administered, then you should not eat or drink after midnight on day of the procedure unless otherwise instructed.
DO TAKE ALL OTHER USUAL MEDICATIONS WITH SMALL AMOUNTS OF WATER ON THE DAY OF THE PROCEDURE EXCEPT THE MEDICINES BELOW THAT SHOULD BE STOPPED SEVERAL DAYS IN ADVANCE OF THE PROCEDURE
You will need a driver afterwards that can stay in our lobby during the entire time you are in our facility.
MEDICATIONS TO STOP BEFORE THE PROCEDURE:
What to expect from the procedure:
The point of the procedure is to reproduce the normal daily pain. During the injection, a second type of pain (due to the needles themselves) is usually felt to the right or left of the spine depending on the location of the needles, but this type of pain is different than the usual pain.
What to do after the procedure:
Bleeding, infection of the disc space, nerve injury, spinal cord injury, spinal headache, abscess or blood clots, paralysis are all rare risks that you should discuss with your physician prior to the procedure