Discogram

A discogram or diskogram has the ability to help your doctor in determining if an abnormal disk in your spine is causing you back pain as a test to evaluate back pain. 

Spinal disks have the appearance of little jelly doughnuts, with a tough outer layer and a gel-like substance inside. Disk function as shock absorbers or cushions in the spine.

A dye is injected into the soft center of the disk, during the discogram. In some cases, this injection itself can lead to back pain.

Several discs may be injected in the attempt to pinpoint the cause of your pain. The dye also moves into the cracks in the disk’s exterior, which is clearly visible on a CT scan or an X-ray.

However, the discs that do not show any signs of wear and tear do not always cause symptoms, this makes the usefulness of the discogram controversial.

Here are the most common reasons to undergo discogram test.

A discogram is an invasive test procedure that is not generally used for an initial evaluation of back pain.

However, a doctor can suggest a discogram if your back pain continues despite treatments, such as medications and physical therapy. 

In some cases, doctors use a discogram before spinal fusion surgery to help identify which disks need to be taken out.

However, discograms cannot always be depended on to be accurate in pinpointing which disks, if any, are causing back pain.

The majority of doctors instead rely on other testing methods, such as MRI and CT scanning, to diagnose disk problems and guide treatment.

In general, discogram is a harmless procedure. However, like with any other medical procedure, it carries a number of risks which can possibly include the following:

• Infection
• Headache
• Worsening of chronic back pain
• Injury to the nerves in and around the spine
• An allergic reaction to the dye used during the procedure

In order to prepare for a discogram, you may initially need to avoid any blood-thinning medications for a period of time prior to the procedure.

Your doctor will give you specific instructions about what medicine you can and cannot take. You are also required to avoid food and drink the morning before your tests.

Here’s what you can expect before, during, and after your discogram.

The total time for the test is about three hours, the discogram itself takes about 30 minutes. You'll be able to go home later that same day.

During a Discogram

A discogram is performed in a clinic or hospital room that has the imaging equipment. You are awake during the procedure, but your doctor may give you a sedative through a vein to help you relax. You may also receive antibiotics to help prevent infection.

During the procedure, you lie on a table on your abdomen. After cleaning your skin, your doctor may inject a numbing medicine to decrease pain caused by the insertion of the discography needles.

Your doctor will use an imaging technique (fluoroscopy) that enables him or her to watch as the needle enters your body.

Fluoroscopy allows more precise and safer placement of the needle into the center of the disk to be examined. A contrast dye is then injected into the disk, and an X-ray or CT scan is taken to see if the dye spreads.

If the dye stays in the center of the disk, the disk is normal. If the dye spreads outside the center of the disk, the disk has undergone some wear-and-tear change. These changes may or may not be the cause of your pain.

Typically, if a disk is causing your back pain, you will feel pain during the injection that's similar to the back pain you have daily. If a disk is normal, there's little pain during injection. During discography, you will be asked to rate your pain.

After a Discogram

You remain in the procedure room for approximately 30 minutes to one hour for observation. Someone will need to drive you home.

It is normal to have some pain at the injection site or in the low back for several hours after the procedure. You will need to keep your back dry for 24 hours after the procedure.

If you develop severe back pain or you develop a fever one to two weeks after the procedure, call your doctor right away.

Your doctor will proceed to view the results and the information you gave him about the pain you experienced during the discogram.

Both of these are vital in pinpointing the source of your back pain. Your doctor will make use of this information to guide your ongoing treatment or prepare for surgery.

Doctors do not usually rely on the results of the discogram alone to be able to guide treatment. This is because wear-and-tear changes in a disc might not cause pain. Also, pain responses during a discogram can vary widely.

Typically, the results of a discogram are combined with results of other tests, such as MRI or CT scan and physical examination when determining the treatment plan for back pain.