Introduction
A discogram, or discography, is a specialized diagnostic procedure used to evaluate back pain originating from spinal discs. It helps doctors determine if a specific disc is the source of pain, often aiding in the decision-making process for surgical interventions like spinal fusion. Unlike imaging tests like MRIs or X-rays, a discogram provides functional information by assessing pain response to pressure on the disc.
Why Is a Discogram Performed?
A discogram is typically recommended for patients experiencing chronic back pain that has not responded to conservative treatments such as medication, physical therapy, or injections. It is used to:
● Identify painful or damaged discs in the spine
● Evaluate patients for potential spinal surgery
● Differentiate disc-related pain from other spinal conditions
How to Prepare for a Discogram
Before the procedure, your doctor will provide specific instructions, which may include:
● Fasting: Avoid eating or drinking for several hours before the procedure
● Medication adjustments: Certain blood thinners and anti-inflammatory medications may need to be stopped
● Arranging transportation: Due to sedation, you will need someone to drive you home
The Discogram Procedure: Step-by-Step
Positioning and Preparation
○ The patient lies on their stomach or side on an X-ray table.
○ An intravenous (IV) line may be inserted for sedation or antibiotics.
Local Anesthesia
○ A local anesthetic is injected to numb the skin and surrounding tissues.
○ Some patients receive mild sedation, though they remain awake to communicate pain levels.
Needle Insertion
○ Using fluoroscopic (real-time X-ray) guidance, a thin needle is carefully inserted into one or more spinal discs.
○ A contrast dye is injected into each disc to assess its integrity and provoke symptoms.
Pain Evaluation
○ The doctor asks the patient to describe any pain experienced during the injection.
○ If the injected disc reproduces the patient’s typical pain, it is likely a source of discomfort.
Imaging and Documentation
○ X-ray and CT scans capture images of the injected discs to identify structural abnormalities.
○ The results help guide treatment recommendations.
Risks and Potential Complications
While generally safe, a discogram carries some risks, including:
● Temporary pain flare-ups
● Infection
● Bleeding
● Nerve damage (rare)
● Allergic reaction to contrast dye
What Happens After a Discogram?
● Patients rest for a short period and are monitored before being discharged.
● Mild discomfort may persist for a few days, managed with over-the-counter pain relievers.
● The doctor will review the results and discuss potential treatment options, such as physical therapy, pain management, or surgery.
Conclusion
A discogram is a valuable tool for diagnosing disc-related back pain and determining the best course of treatment. While it involves some discomfort, it provides critical information for targeted pain management and surgical planning. If you’re experiencing chronic back pain and considering a discogram, consult your doctor to understand if this procedure is right for you.