Sarah Lewis, PharmD
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.
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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:
You will dress in a patient gown and lie on a procedure table.
Your imaging team will insert an intravenous (IV) line to provide fluids and medications.
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.
Your imaging team will attach devices to monitor your vital signs.
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.
Your imaging team will shave, clean and cover the affected area of your spine with a surgical drape.
Your radiologist will numb the skin with an injection of local anesthetic.
Your radiologist will insert a needle through your skin and into the spinal disc. Real-time X-ray guidance will guide proper needle placement.
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.
The radiologist repeats the process for all discs that are studied.
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.
The disc injections will reproduce your pain symptoms (if caused by a disc problem). You will have enough sedation so that you stay relaxed with minimal discomfort. Take a few long, deep breaths to help yourself relax. Tell your care team if any discomfort does not pass quickly.
What are the risks and potential complications of a discogram?
Complications after a discogram are uncommon, but any medical procedure involves risk and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or recovery. Risks and potential complications of a discogram include:
Adverse reaction or problems related to the contrast dye, sedation, or other medications, such as an allergic reaction and problems with breathing
Exposure to radiation, which may be harmful in excessive doses. Your care team follows strict standards for X-ray techniques and will use the lowest amount of radiation possible to make the best images.
Nerve or blood vessel damage
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
Informing your doctor or radiologist if you are nursing or if there is any possibility of pregnancy
Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my discogram?
You are an important member of your own healthcare team. The steps you take before procedure discogram can improve your comfort and help ensure the most accurate test results.
You can prepare for a discogram by:
Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Arranging for a ride home if sedation will be used during your discogram
Following instructions about eating and drinking before a discogram
Getting all necessary laboratory testing completed before your procedure
Leaving jewelry, metal objects, credit cards, and other valuables at home
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.
Questions to ask your doctor
Preparing for a discogram can be stressful. It is common for patients to forget some of their questions during a brief doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before a discogram and between appointments.
It is a good idea to bring a list of questions to your appointments. Questions can include:
Why do I need a discogram? Are there any other options for diagnosing my condition?
How long will the procedure take? When can I go home?
What restrictions will I have after the procedure? When can return to work and other activities?
What kind of assistance will I need at home? Will I need a ride home?
How should I take my medications?
How will you treat my pain? When and how will I receive the results of my test?
What other tests or treatments might I need?
When should I follow up with you?
When and how should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my discogram?
Knowing what to expect after a discogram can help you get back to your everyday life as soon as possible.
How will I feel after the discogram?
You may have a temporary increase in back pain or pain at the injection site for several hours after your discogram. Apply ice packs and take your pain medication as directed by your doctor. You might also feel drowsy from the sedative medication. Call your doctor if your pain gets worse or changes in any way because it may be a sign of a complication.
When can I go home?
You will stay in the outpatient facility or hospital for about 30 minutes to an hour after your discogram.
When should I call my doctor?
It is important to keep your follow-up appointments after a discogram. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Fever (you should not have any fever after this type of testing procedure)
Inability to move a body part
Numbness or weakness
Pain that is not controlled by your pain medication
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- Discogram. American College of Radiology. http://www.radiologyinfo.org/en/info.cfm?pg=discography
- Discogram. Mayfield Clinic for the Brain and Spine. http://www.mayfieldclinic.com/PE-DISCO.htm
- Discogram. University of Rochester Medical Center. http://www.urmc.rochester.edu/imaging/patients/procedures/discogram.cfm
- Discography. North American Spine Society. http://www.knowyourback.org/Pages/Treatments/AssessmentTools/Discography.aspx
- Evaluating postoperative fever: A focused approach. Cleveland Clinic Journal of Medicine. http://ccjm.org/content/73/Suppl_1/S62.full.pdf