Discography or a discogram is a diagnostic procedure used to help diagnose the source of neck or back pain. There are many structures in the spine which may become painful. A discogram is a test used to identify a painful disc. During a discogram a needle is inserted into a disc and a liquid dye is injected. If the dye causes a reproduction of the pain, it is very likely that the disc injected is the source of the pain. If the dye does not cause pain, it is unlikely that the disc is the source of pain. This test is usually performed when more than one disc looks abnormal on the MRI and surgery is being considered. The goal is to determine which disc is the painful one so that surgery can target the appropriate disc.
Can I be “put out” for it? You may have some mild sedation during the placement of the needles, but you need to awake for the test part of the procedure to tell us how you feel. You will also have a local anesthetic to numb your back before the needles are placed.
The procedure usually takes 20 to 30 minutes depending on how many discs need to be tested, but you will need to be at the hospital or surgery center for about 60 to 90 minutes from check-in and check-out.
A contrast dye which is mixed with an antibiotic to prevent infection. It there is pain, this can be followed by a local anesthetic to numb it. There are no steroids injected. It is a diagnostic test, not a treatment.
Side effects are rare, but may include a temporary increase in pain or vasovagal reaction (fainting).
There potential main complications include: bleeding, infection, allergic reaction, or nerve damage. These are all very rare when the appropriate precautions are taken. Injections in the cervical spine (neck) are always inherently riskier than injections in the lumbar spine (lower back). The main risk of discography is an infection of the disc called diskitis. In order to prevent this, intravenous antibiotics are given before the procedure and more antibiotics are injected into the disc (mixed with the dye) during the procedure.
You must stop any blood thinning medication 7 to 10 days before the procedure to prevent bleeding. This includes aspirin, coumadin, plavix, pradaxa, effient, advil, motrin, aleve, naprosyn/naproxen, ibuprofen, excedrin, any cold or sinus medication containing these, and other anti-inflammatory medications. If you are not sure if you need to stop a medication, you should ask. Diabetes medication may need to be held the morning of the procedure if you do not eat breakfast. Blood pressure and other heart medications should be continued.
When can I go back to work? No. You may feel soreness for the next few hours and want to “take it easy,” but there is no need to stay in bed. You may return to work the next day.
You should avoid submerging your back in water for 2-3 days after the injection. This includes a bath, hot tub, swimming pool, or the ocean. You may shower the night after the injection, unless told not to by the doctor.
You should not travel long distance for one week after the injection.
Dr. Baker has many years of experience performing these injections. She is a member of the International Spine Intervention Society and regularly attends meetings, conferences, and workshops to remain up to date on the latest innovations in spine care.