DISCOGRAPHY

Discography is an interventional diagnostic imaging test that uses imaging guidance (either X-ray or CT) to inject a contrast liquid, or dye, into the center of one or more spinal discs to help identify the source of back pain. The test is also used to help inform the treatment of abnormal sponge-like cushions located between the vertebrae of the spine, called intervertebral discs.

A discogram is typically done after conservative treatment, such as physical therapy or medication, over the course of four to six months has failed to alleviate back pain. The results of a discogram are usually reviewed alongside other tests and used to inform the creation of a comprehensive treatment plan.

Physician describing discography to female patient

Benefits of Discography

The benefits of a discogram include:

Diagnostic capability
No radiation in the body after an X-ray exam
Painless, noninvasive, and accurate
Detailed imaging of both bone, soft tissue, and blood vessels provided by a CT scan

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Risks of Discography

If the physician uses a contrast material during the procedure, there is a minimal risk of allergic reaction. Though excessive scanning increases the risk of cancer, the benefits of an accurate diagnosis outweigh the risks.

The procedure is generally safe, but patients may experience the following complications:

Nausea
Bleeding
Nerve damage
Infection of the injected discs
Headache
Injury to the blood vessels or nerves in and around the spine
Paralysis
Temporary worsening of chronic back pain
Temporary numbness or weakness

Medical room used to perform discography

How to Prepare

To ensure patients are good candidates for the procedure, they may need to undergo a blood test that analyzes kidney function and blood clotting.

It’s important to:

Inform the doctor of current medications and herbal supplements, and recent illnesses or other medical conditions.
Report any allergies, especially to local anesthetic, general anesthesia, or contrast materials.
Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and blood thinners before the procedure.
Avoid eating or drinking anything after midnight before the procedure.
Plan to have someone drive the patient home after the procedure.

Women should tell their doctor and technologist if they are pregnant or suspect they may be pregnant. Exposing the fetus to radiation during the procedure could cause serious harm.

What to Expect During The Procedure

The patient will be positioned on their side on the examining table, and slightly rolled forward. Staff will place pillows to keep the patient comfortable and in position and insert an IV. The treatment area will then be cleaned, shaved, and covered with a surgical drape.

Next, the physician will numb the area with a local anesthetic and use fluoroscopy to insert a needle into the center of the disc being examined. Once the needle has been inserted, the physician will inject a contrast material and remove the needle.

Throughout the procedure, the patient will be asked to describe the location, distribution, and severity of their pain. The process will be repeated for additional discs, and the patient will not be told which disc is being injected to ensure the test’s objectivity.