- Images the structural integrity of the disc
- Provides real-time information for detailed diagnostics
- Aids in treatment planning
- Minimally invasive
- Performed on an outpatient basis
Discography is an imaging procedure used to determine which discs are causing pain and to what extent. Diagnostic accuracy studies show strong evidence that discography is a useful tool for imaging disc morphology missed by MRI and other tests.1 By injecting dye into one or more discs while monitoring for reproduction of your back pain, the doctor can identify which of the discs is the source of pain. Discography can detect structural damage in a disc and show if a disc has begun to rupture or has tears in its outer ring—helping to ensure optimal treatment planning.
Under x-ray guidance, a thin guide needle is inserted into one or more discs. The discs are then pressurized one at a time with contrast dye to outline any damaged areas. If you experience pain that feels like your usual pain, that disc can be classified as a pain generating or symptomatic disc. During the procedure, your answers to questions about the intensity, type, and location of the pressure will help determine your diagnosis and appropriate treatment options.
A degenerated disc is no longer able to act as an effective cushion between vertebrae
Before the procedure
If the patient is a good candidate, the doctor will review:
- Recent x-rays, MRI films, and reports
- Current medications, including herbal supplements, and their dosages
- Drug, iodine, x-ray dye, or latex allergies
- Current health conditions
The physician or the healthcare staff will also request that the patient:
- Abstain from aspirin, ASA-containing products (including Alka-Seltzer® or Pepto-Bismol®) and herbal remedies for 5 days before the procedure
- Abstain from ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDS) for 3 days before the procedure
- Abstain from eating or drinking for at least 6 hours before the procedure, except necessary medications with sips of water
- Arrange for someone to drive home after the procedure
During the procedure
Discography typically takes about 30-60 minutes to perform. During that time the patient will be awake but sedated so that they can tell the doctor what they are feeling as the procedure progresses.
To begin, a local anesthetic is used to numb the skin and all the tissue down to the disc area. Using x-ray guidance, a needle is inserted into the center of the disc. This process may be repeated for multiple discs.
Once all the needles are placed, the discs are pressurized one at a time with injections of contrast dye. With each injection, the patient will feel either pressure or pain. If they feel pain, the doctor will ask how it compares to the usual pain in terms of type, intensity on a scale of 1 to 10, and location.
After each disc is tested, x-rays are taken and the needles are removed. The patient may be taken for a CT scan to obtain additional information about the exact pattern spread of dye through or out of the disc.
After the procedure
Typically patients go home within 30 minutes to an hour. The patient may experience soreness for a few days. The doctor will usually recommend taking non-prescription pain and anti-inflammatory medications as well as icing the treatment area for 20 to 30 minutes each day until the soreness subsides. The patient may also be advised to limit driving, twisting, and lifting anything weighing more than 10 pounds for a few days.