What is a discogram?

A discogram is a diagnostic X-ray 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, 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. 

Your doctor may only consider procedure discogram if other options with less risk of complications have been ineffective in diagnosing or treating your condition. Other options involve medication, physical therapy, and modifying activities for at least four to six months without back pain relief.

A discogram is only one method used to diagnose the cause of back pain and identify spinal disc problems. Discuss all of your diagnostic options with your doctor to understand which options are right for you.  

Other procedures that may be performed

Your doctor may perform other procedures in addition to a discogram to diagnose spinal conditions. These include additional X-rays, CT (computed tomography) scans, and MRI (magnetic resonance imaging).

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. A discogram is a diagnostic tool that duplicates your back pain symptoms. This helps pinpoint which discs, if any, are involved.

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

Who performs a discogram?

Several types of radiologists perform discograms including: 

  • Radiologists, also known as diagnostic radiologists, are doctors who specialize in performing and interpreting imaging tests.
  • Neuroradiologists are radiologists who specialize in diagnosing and treating diseases and conditions of the brain, spine, head, neck and nerves using radiation and other imaging technologies.
  • Vascular and interventional radiologists are radiologists who specialize in diagnosing and treating diseases using radiological imaging techniques.

How is a discogram performed?

Your discogram will be performed in a hospital or outpatient imaging setting. The procedure takes about an hour and 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 have a light sedative for relaxation. You will remain awake during a discogram so you can communicate about pain and other symptoms you have.
  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 have pillows and supports for comfort and to position you 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. Your radiologist will inject a contrast agent into the disc and then remove the needle. You will describe 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 important to you and your care team. You may feel a 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.&