Discogram

What is a discogram?

A discogram is a diagnostic X-ray procedure that allows your doctor to examine the discs in your spine. Spinal discs are located between each vertebra (bone) in your spine. Discs act as cushions to protect your spine and provide back flexibility. A discogram, also called discography, is an important test that can help determine if your back pain is caused by a spinal disc problem, such as a herniated disc. Your doctor may also use a discogram to guide treatment of diseased discs.

A discogram involves the injection of contrast (dye) into selected discs. If your back pain is due to a diseased disc, the increase in pressure from the contrast material may cause temporary pain that mimics your normal back pain. Because of this, your doctor may only consider the procedure if other options that involve less risk of complications have been ineffective in diagnosing or treating your condition. These may involve medication, physical therapy, and modifying activities for at least four to six months without satisfactory back pain relief.

A discogram is only one method that your doctor can use to diagnose the cause of back pain and identify spinal disc problems.You should discuss different screening options with your doctor or healthcare provider to best understand which option is right for you. 

Other procedures that may be performed

In addition to a discogram, your doctor may also recommend one or more other procedures to diagnose spinal conditions. These include additional X-rays, computed tomography (CT) images, or magnetic resonance imaging (MRI).

Why is a discogram performed?

Your doctor may recommend a discogram to determine if your back pain is due to problems in specific spinal discs. It is a very specific diagnostic tool that duplicates your typical back pain symptoms. This helps pinpoint which discs, if any, are involved.

Doctors can also use a discogram to help develop new treatment plans for certain patients with back pain. Patients include those who have not had satisfactory back pain relief for four to six months, despite treatment with medications, physical therapy, and activity modification.

How is a discogram performed?                  

A radiologist will perform your discogram in a hospital or outpatient imaging setting. A radiologist is a physician who is specialized in medical imaging. Your radiologist may lead a radiological imaging team. The procedure takes about an hourand generally includes these steps:

1. You will dress in a patient gown and lie on a procedure table.
2. Your imaging team will insert an intravenous (IV) line to provide fluids and medications.
3. You will receive a light sedative for relaxation. However, you must remain awake during a discogram so you can communicate about any pain or other symptoms you experience.
4. Your imaging team will attach devices to monitor your vital signs.
5. You will lie on your side, rolled slightly forward to expose your spine. You will receive pillows and supports to provide comfort and help keep you positioned properly.
6. Your imaging team will shave, clean and cover the affected area of your spine with a surgical drape.
7. Your radiologist will numb the skin with an injection of local anesthetic.
8. Your radiologist will insert a needle through your skin and into the spinal disc. Real-time X-ray guidance will guide proper needle placement.
9. Once the needle is in place, your radiologist will inject a contrast agent into the disc and then remove the needle. You will need to communicate any symptoms you experience during the procedure. This helps the radiologist determine if the injections reproduce your back pain and which discs are affected.
10. The radiologist repeats the process for all discs that are studied.
11. The imaging team may take additional X-ray or CT images once the injections are complete.

Will I feel pain?

Your comfort and relaxation is very important to both you and your care team. You may feela brief pinch or prick during IV insertion. You may also feel brief stinging during injection of the local anesthetic in the skin of your back.