A discogram (discography) is a specialized diagnostic imaging procedure used to evaluate the intervertebral discs of the spine. These discs cushion the spine’s vertebrae. A discogram aims to determine if a specific spinal disc is the source of a patient’s back or neck pain, particularly when other diagnostic methods have not yielded conclusive results.
What a Discogram Involves
The discogram procedure involves injecting a contrast dye directly into the nucleus of one or more spinal discs. Fluoroscopic guidance (real-time X-ray) ensures precise needle placement.
During the injection, the patient is asked to describe and rate any pain experienced. This pain response is a significant part of the diagnostic process, as it aims to reproduce the patient’s typical pain symptoms to identify the problematic disc. Immediately following injection, X-rays or CT scans visualize how the contrast dye spreads within the disc. If the dye remains contained, the disc may be healthy; if it spreads beyond the disc’s center, it can indicate structural changes or damage.
Reasons for Undergoing a Discogram
Discograms are typically considered when chronic back or neck pain persists despite other diagnostic tests, such as MRI or CT scans, failing to conclusively identify the pain source. It is particularly helpful when other imaging shows structural abnormalities but cannot confirm if those discs generate pain.
Healthcare professionals may recommend a discogram when considering surgical interventions, such as spinal fusion or disc replacement. Identifying the precise pain-generating disc is important for guiding these procedures and ensuring treatment targets the problem. The test helps differentiate between pain originating from a disc and pain from other sources in the spine.
Preparing for and Recovering from a Discogram
Preparation for a discogram includes specific instructions. Patients may need to fast for several hours before the procedure. Patients should discuss all current medications and allergies with their doctor, as some, like blood thinners, may need to be discontinued. Arranging for transportation home is important, as light sedation may be administered, or discomfort could affect driving ability.
Following the discogram, patients may experience a temporary increase in back pain, common due to disc irritation from the injection. Soreness at the injection site is expected. Post-procedure care typically involves rest, applying ice or heat, and taking prescribed pain medication to manage discomfort. While normal activities can usually resume the next day, strenuous activities should be avoided for a short period.
Interpreting Discogram Results and Next Steps
Discogram results are interpreted based on the patient’s pain response during injection and the disc’s appearance on imaging. If the injection reproduces the patient’s familiar pain (known as concordant pain reproduction), it suggests that disc is a source of their symptoms. Post-injection X-rays or CT scans provide visual information on the disc’s morphology and how the contrast dye disperses, indicating structural damage.
A “positive” discogram, where a specific disc is identified as pain-generating, helps guide treatment options. This can lead to targeted interventions, which might include specific injections, or surgical considerations like fusion or disc replacement, aimed at addressing the problematic disc. Conversely, a “negative” discogram implies the tested discs are likely not the primary pain source, prompting further investigation into other potential causes.