What is a Discography?
Discography is a diagnostic procedure where x-ray dye is injected under mild pressure into one or more spinal discs. The doctor can make a determination if the disc is responsible for pain based on the absence or presence of pain during the dye injection. After x-ray dye is injected, a picture is taken of the discs (called a discogram), which will show if there are any tears (fissures) in the disc lining.
How do I know if my pain comes from a damaged disc?
During the discography procedure, the doctor inserts a needle into the disc. Using gentle pressure, the doctor then injects contrast dye into the disc. If the pain that occurs when dye is injected is the same as your back pain (called concordant pain), the doctor will know that the disc is responsible for the back pain.
How is the discography procedure done?
You will first sign a consent form and change into a procedure gown. After starting an IV line in your arm, the nurse will position you on your stomach. The doctor will administer a mild sedative to keep you comfortable. After cleansing the skin over the injection site on the back, the procedure needle is carefully inserted into the disc using x-ray guidance for correct placement. The doctor gently injects the contrast dye into the disc and asks you about your pain. After removing the needle, a small bandage is applied.
Does discography hurt?
All procedures first begin with injecting the skin and deeper tissues with a local anesthetic. You will only feel a slight pinch and then a mild burning sensation. Once the tissues are numb, you will feel pressure when the needle goes into the disc. When the disc is injected with the contrast dye, you will experience the same pain you feel with your backache – or nothing at all. This is how the doctor determines if the disc is damaged or not. After the procedure, you may feel some soreness at the injection site, but this resolves within 8-24 hours.
Will I be put to sleep for the procedure?
Because the doctor has to ask you questions about what you are feeling during the discography, the procedure is performed using a mild sedative, not general anesthesia. Be sure to discuss the use of a sedative beforehand with the doctor.
How many discs are injected at one time?
The total time for a discography is around 60-90 minutes. Based on your MRI results, the doctor will inject 1-3 discs during a procedure.
What can I expect after the procedure?
After your discography procedure, you will be monitored by a nurse in the recovery room for around 45 minutes. Your back may feel numb for several minutes. We recommend that you take it easy for 1-2 days before returning to work. Go about your usual activities as tolerated.
Who can NOT have a discography procedure?
Certain people cannot have a discography. These include people who:
- Are taking blood-thinning medications
- Have an active infection
- Are allergic to contrast dye or anesthetics
Does the discography work for diagnosing back problems?
Discography is a diagnostic procedure and offers no therapeutic benefits. According to a recent study, this procedure is the only technique useful for determining if or not back pain is related to a disc. Researchers found it a valid test for diagnosing disc problems.
Resources
Stout A (2010). Discography. Phys Med Rehabil Clin N Am, 21(4), 859-867.