Discography is a test performed to determine which disc, or discs, if any, are related to your pain and if there is any disc degeneration. Many people have discs that look abnormal on an MRI, but are not related to their pain. Discography can be performed in the lumbar spine (low back), cervical spine (neck) and less often in the thoracic spine (mid-back).
The test has two parts that provide your doctor with helpful information. The test involves injecting a dye that can be seen on x-rays into the center of the discs. This is the imaging part of the test. In a normal disc, without degenerative changes or tears, the dye stays in the center of the disc. If the disc has torn fibers, the dye spreads into the damaged areas. If the disc is severely degenerated, the dye spreads throughout.
The second part of the evaluation is pain assessment. Information about the location and intensity of pain experienced during the injection will help your doctor to determine which disc(s), if any, are related to the pain for which you are seeking treatment.
Before the Procedure
- Do not eat any solid foods after midnight prior to your discogram. You may have clear liquids the morning before your discogram.
- Dress comfortably in a warm-up suit, sweats or shorts; you will need to change into a gown.
- Let the nurse and doctor know if you are pregnant or may be pregnant, are diabetic, have a history of epilepsy or seizure, are allergic to any medication or have had any reaction to x-ray dye or xylocaine.
During the Procedure
- You will lie on your stomach and side.
- Patients are generally given a light sedative but need to be awake to provide information during the evaluation.
- The skin in the area of the injection will be cleaned.
- A local anesthetic will be injected.
- Fluoroscopy, a method used to make images, will be used as the physician passes the needles into the discs. Generally, three discs in the lumbar spine are tested. Fewer may be injected in the cervical spine.
- Dye will be injected into each disc tested.
- As the injection is made into each disc, the doctor will ask you questions about the location and intensity of any pain that the injection provokes.
- X-rays will be made.
- The procedure usually takes about 40 minutes.
After the Procedure
- Often, a CT scan after the discogram to get as much information as possible about the structure of the discs.
- You will be in a recovery room for about 30 minutes.
- You must have someone to take you home.
You will have a follow-up appointment with Dr. Stephens after the discogram to discuss the findings.
Why should you consider kyphoplasty?
- Kyphoplasty can be very helpful when there is a severe collapse of the broken vertebra or wedging, with more collapse in the front of the spine than the back resulting in the spine tending to tilt forward.
- By correcting the wedging, kyphoplasty may help restore the spine to more normal alignment and prevent severe “hunchback” deformity to the spine.
- In someone who has had multiple fractures with previous wedging, kyphoplasty can prevent further worsening of the deformity.