Diagnostic Discography

Lumbar discogram showing two normal discs above and below an abnormal disc with a large posterior tear

Discography is a tool to determine the precise source of back pain due to a specific intervertebral disc between affected vertebrae.

Discograms are safe and well-tolerated by most patients. While the risk-benefit ratio of diagnostic discograms is very good, they are usually done only after less invasive tests and procedures have failed to provide a satisfactory diagnosis and/or treatment. In many instances, pain specialists at Synergy Spine Center will recommend discograms prior to intra-discal treatments such as laser disc decompression or endoscopic spinal surgery. The major risk of the procedure is infection, or discitis, which is rare and usually treated with antibiotics. Rarely does it require surgery to eradicate.

What to Expect

  • The patient enters the preparation area where an IV line is inserted.
  • Pre-operative antibiotics are given to reduce the chance of infection from the procedure.
  • Light sedation may also be given if desired. It is important not to over sedate the patient to allow an appropriate degree of verbal feedback of the response to disc injection.
  • The patient is taken to the procedure or operating room and placed face down on the procedure table with a pillow under the abdomen for lumbar procedures, or face up with a pillow under the head for cervical procedures.
  • The x-ray camera is properly adjusted to see the disc clearly in multiple projections.
  • The skin overlying the injection area is antiseptically cleansed and draped with sterile towels.
  • Local anesthetic is used to numb the skin.
  • A needle is placed into the center of the disc using x-ray guidance.
  • Dye is slowly injected while the physician carefully notes the feel of the disc, the appearance of the images produced, and, most importantly, the response of the patient.
  • At the completion of the procedure, local anesthetic may also be injected into any painful discs to decrease the pain response which may have been caused by the discogram itself.
  • All needles are removed, the patient is observed in the recovery room for a short while, before being discharged to go home.

Post-Procedural Follow-up

  • Avoid being on your feet for 2-3 hours following the facet joint injection.
  • Do not drive or operate dangerous equipment or machinery during this time.
  • Notify clinic staff if you experience prolonged pain at the injection site, fever, chills, dizziness, or leg or arm numbness that lasts more than 2-3 hours.
  • A drop or two of blood at the injection site is normal. Contact the office if you experience persistent bleeding or drainage at the injection site and follow all instructions for further care.
  • Expect to see results from the injection with 2-5 days. You may experience continued improvement over the next several days, and full benefit may take as long as two weeks to occur.
  • You may use any supplemental pain medications during this time.
  • Remember, follow-up care is essential to determine the success or failure of the procedure, and to plan further care based on the results.
  • Contact Synergy Spine Center staff with any additional questions or concerns.

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