What is discography?
Discography is a diagnostic tool used to determine whether certain discs of the spine are the source of a patient’s neck or back pain. Discography is often used to diagnose the cause of low back and neck pain, especially when non-invasive imaging (such as MRI) does not reveal abnormalities consistent with the pain symptoms.
Who is a good candidate for discography?
Discography is considered for patients who experience disabling low back pain, neck pain, and arm or leg radiation pain when other conservative methods have failed. Typically patients who undergo discography have not gotten satisfactory pain relief from other measures including medication, physical therapy, and modified activities.
Conditions related to discography
Conditions that are related to discography are those which can produce chronic pain affecting the vertebrae, including spinal stenosis, vertebral body fractures, osteoporosis, osteoarthritis, spondylolisthesis, neoplasms (primary vs. metastatic lesions), infections, bulging and leaking discs, disc disease, and degenerative disc disease.
How discography works
Before the procedure begins, your skin will be appropriately cleaned to decrease the risk of infection. A small needle with local anesthetic will then be injected into your skin to numb the area before a larger needle is inserted. A larger needle is then inserted through the anesthetized skin and is positioned near the outer layer of the disc. Fluoroscopy, real-time X-ray, is used in order to assure proper placement of the needle.
A contrast solution is injected into the disc, and your response to the injection is observed at different locations. If pain is experienced that is similar to your chronic pain condition, then it is possible that your doctor has located the source of your pain. This process is typically repeated at two additional levels. The procedure generally takes about 30 minutes to an hour. Your pain physician may instruct you to go for a CT exam directly after the discogram to better localize contrast dye spread.