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Discs act as soft, pillow-like buffers that divide the spine’s bones. A disc can trigger pain when it bulges, herniates, tears, or degenerates, leading to discomfort in the neck, mid-back, low back, arms, chest wall, abdomen, or legs.
A diagnostic discogram is a procedure performed to ascertain or exclude the disc(s) as the origin of the pain. During this operation, a needle is inserted into the discs under X-ray guidance, and contrast (dye) is injected. CT and MRI scans only display anatomy and cannot definitively pinpoint the source of a patient’s pain. In certain cases, discs might appear abnormal on MRI or CT scans but not be pain generators. Discography aims to identify the pain-causing disc(s), assisting the surgeon in planning an appropriate surgery or avoiding an unhelpful one. Discography can also help determine the suitable discs for IDET (Intradiscal Electrothermal Therapy).
Pre-injection Guidelines: Please ensure you notify our staff if you have an allergy, particularly to iodine. If you’re scheduled for sedation, you must refrain from eating on the morning of the procedure. Insulin-dependent diabetic patients receiving sedation may need to adjust their morning insulin dose due to fasting. Patients may continue taking their routine medications, such as those for high blood pressure and diabetes (e.g., Glucophage).
Patients should persist in taking their standard pain or anti-inflammatory medications on the procedure day. Those on blood thinners like Coumadin should inform the staff to devise an appropriate plan for ceasing the medication before the procedure. We generally advise a designated driver to accompany the patient to ensure their safe return home post-procedure.
Procedure Details: An IV is initiated to administer antibiotics (to prevent infection) and sedatives. Patients lie on their back for cervical discography and on their stomach for lumbar discography. The neck or back skin is cleaned with sterile soap. Subsequently, the physician numbs a small skin area with a local anesthetic, which may sting momentarily. Once the numbing agent takes effect, the physician guides a small needle into the disc spaces using X-ray assistance. Temporary discomfort is common as the needle traverses the muscle or approaches a nerve root. The physician may perform this at multiple disc levels. Once the needles are correctly positioned, a small volume of contrast (dye) is injected into each disc. It is crucial for the patient to communicate to the physician if the injection causes pain and if it matches their typical pain.
Post-procedure Expectations: Patients are typically prescribed antibiotics to take for several days post-procedure. Some muscle discomfort may be experienced, and pain levels might escalate following the procedure. Temporary hoarseness may occur after cervical discography.
Patients can generally resume normal activities the day after the procedure, although driving is discouraged on the procedure day.