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A discogram is a diagnostic test where x-ray dye (contrast) is injected into one or more spinal discs. This procedure is done to evaluate the disc(s) for fissures, tears, and damage. The results of a discogram can help the doctor plan your treatment.

What is the purpose of the lumbar discogram?

When a patient has persistent low back pain, the doctor may suspect it is discogenic (disc-related) in nature. The discogram is a diagnostic procedure that uses injected contrast dye that goes into the discs of the spine. The discogram will not treat the disc, but it will allow the doctor to devise an appropriate treatment plan.

How does the discogram work?

With age and injury, the disc outer tough layers degenerated, which is called degenerative disc disease. Additionally, the disc wall can and does weaken, bulge out, and cause pain due to herniation. During the discogram, the injected fluid will cause pain in a diseased and damaged disc.

What can I expect during the discogram?

When you have the procedure, a nurse attaches monitoring devices to assess your heart rhythm, oxygen level, blood pressure, and hear rate. After you are on the table, the nurse will clean your back using an antiseptic solution. The doctor numbs the skin and deeper tissues with a local anesthetic. The procedure needle is guided into the affected disc using fluoroscopic x-ray guidance. The doctor watches on the monitor screen. As the dye is injected, the doctor will ask questions about what you are feeling. Expect to feel some pressure and mild pain.

Does the discogram hurt?

When a healthy, normal disc is injected, you feel no pain, just pressure. However, when a degenerative disc is injected, you will notice some pain. This only last a brief few seconds. After the procedure, you will have some soreness at the needle insertion sites. This can be relieved with anti-inflammatory agents and ice packs. There is no anesthesia used, but you are permitted to have a sedative. This makes you comfortable and curbs anxiety during the lumbar discogram.

What can I expect after the lumbar discogram?

The discogram does not treat your problem. However, it is a diagnostic test that allows the doctor to decide what to do for your degenerative/diseased disc. You are monitored in the recovery area for an hour after the discogram. We recommend you take it easy for a day or two afterwards, and because a sedative is given, you must have someone drive you. Avoid driving, rigorous activities, and lifting for 24-48 hours.

Who should not have the discogram procedure?

If you are allergic to any solutions or medications used during the discogram, you should avoid the procedure. This includes betadine, contrast dye, sedatives, and anesthetics. In addition, you cannot have this test if you have a bleeding condition, serious heart problem requiring anticoagulants, active infection, or are taking chemotherapy.

Is the lumbar discogram effective and purposeful?

Discography is an appropriate diagnostic test for assessing the cause of chronic low back pain. In a 2006 study, researchers evaluated the tests over a 5-year period. Of the 32 patients who had a positive low-pressure provocative discogram, 72% resulted in effective treatment afterwards due to the findings of the test.

Pain and Spine Clinics offers lumbar discogram procedures with a Double Board Certified Phoenix pain management doctor. The procedures are excellent and extremely helpful in determining the source of one’s back pain. Most insurance is accepted at PSC, call today!

Resources

Carragee EJ, Lincoln T, Parmar VS, Alamin T. A gold standard evaluation of the ‘discogenic pain’ diagnosis as determined by provocative discography. Spine. 2006;31(18):2115-2123.