Discography

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A discogram, or discography, is a minimally invasive diagnostic imaging test that helps determine whether a specific intervertebral disc may be the source of back pain. When discs bulge or rupture, they may press on the nerves of the cervical or spinal column and cause pain or weakness.

In a discogram, a contrast material is injected into the center of one or more spinal discs using x-ray guidance. This injection may temporarily reproduce the patient's back pain symptoms. As part of the procedure, an x-ray or CT scan also may be performed to obtain pictures of the disc.

Need to Know

Nice to Know
  • You will be asked to sign a consent form before the procedure is performed
  • Tell your radiologist about any allergies, especially to local or general anesthetics and contrast materials (“x-ray dye”)
  • If you are taking a blood thinner or aspirin product, the physician will instruct you when to stop taking these medications
  • If you are diabetic, the physician will give you insulin and/or anti-diabetic medication dosing instructions
  • Inform your radiologist if you are pregnant
  • You should plan to have someone take you home after the procedure as you will not be able to drive after sedation
  • Following the injections, avoid aspirin, ibuprofen, or other anti-inflammatory drugs for at least 48 hours. Tylenol may be used if needed.
  • You should be healthy the day of the exam. You cannot have a fever, infection, sore throat or cough. You need to call the number provided to you if you need to reschedule the exam.

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How Does It Work?

A saline solution and radiopaque dye are injected into the disc and x-ray pictures are taken to demonstrate annular tears, scarring, disk bulges and changes in the nucleus of the disc.

What Happens — Before, During, and After?

A clinical staff member will bring you into the pre-procedure area and ask you to change into a gown. An intravenous (IV) line will be inserted into a vein in your hand or arm. Your doctor will greet you, review the procedure, and answer any questions you may have. You will be brought into the procedure room, and you‘ll be positioned on the procedure table. You will be connected to a monitor for your heart rate, blood pressure, and pulse. The patient is given intravenous medication as a relaxant and sedative. A local anesthetic is injected into the patient’s skin in the area that is being examined. A needle is inserted into the disk under fluoroscopy. A saline solution and radiopaque dye are injected into the disk and x-ray pictures are taken to demonstrate annular tears, scarring, disk bulges and changes in the nucleus of the disk. After the procedure you will be taken to the recovery area.

You will be provided with written discharge instructions before you leave and preliminary results will be given to you and your driver. You will receive a copy of the discorgram film that is taken. Please take the copy of the discogram pictures to your referring physician when you return for your follow up appointment.

The procedure takes approximately 30-45 minutes. Expect an additional 30-45 min of recovery time.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or – as you’re doing now- educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin, Warfarin, Plavix, Fragmin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a clinical staff member from the Interventional Radiology Department will call you. The clinical staff member will give you any additional instructions, and will ask if you have any questions.
  • Take your medications as instructed.
  • When you arrive, make sure the clinical staff member and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics, or x-ray dye (contrast media). If there’s any chance you might be pregnant, tell your radiologist.
 
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What Should I Bring?

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of Discography include:

  • You can be provided with confirmation of a diagnosis and/or determination of which disc(s) is the source of pain

Risks you should be aware of include:

  • Like any catheterization procedure, there is risk of damage to blood vessels, bruising, bleeding, or infection at the puncture site
  • Spinal headache
  • Damage to the disk
  • Skin reaction to the material injected
  • Seizures
  • Increase pain

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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