This examination is done on an outpatient basis.
A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm so that sedative medication can be given intravenously. You must be awake during the procedure in order to communicate any of the symptoms that you are experiencing during the test.
You may be given medications to help prevent nausea and pain, and antibiotics to help prevent infection.
You will be positioned on the examining table in supine position (on your back) for cervical discography or prone (on your stomach) for thoracic or lumbar discography. You will be connected to monitors that track your heart rate, blood pressure and pulse during the procedure.
Hair at or near the site of the discography procedure may also be shaved.
Your physician will numb the area with a local anesthetic.
Guided by real-time x-ray images (fluoroscopy), the physician will insert a needle through your skin into the center of the disc being examined. Once the needle is inside the disc, contrast material is injected through a manometer (a pressure guage) and x-ray pictures of the disc are obtained and the pressures recorded.
During the procedure you may be asked to describe your pain in terms of location, distribution and severity. If the injected disc is the source of your back pain, you may feel pain similar to what you experience on a day-to-day basis. The process may be repeated for additional discs. In order for the discogram to be considered an objective test, the operator cannot disclose what level is being injected and when the injection is taking place.
Once the needles are withdrawn, pressure will be applied to prevent any bleeding and the opening in the skin is covered with a bandage. No sutures are needed.
Your intravenous line will be removed.
After the injections are complete, a CT scan may be performed to further analyze the injected disc(s). When contrast material spreads outside a disc, it may indicate that there are fissures in the outer ring of the disc.
This procedure is usually completed within one hour, depending on how many disc levels your doctor wants to evaluate.
What should I do to prepare for my procedure?
On the day of your injection, you should not have anything to eat or drink for at least eight (8) hours before your scheduled procedure. You must have someone available to drive you home. If possible, you should shower and use an antibacterial soap like Lever 2000 before your procedure. If you usually take medication for high blood pressure or any kind of heart condition, it is very important that you take this medication at the usual time with a sip of water before your procedure.
If you are taking any type of medication that can thin the blood and cause excessive bleeding, you should discuss with your doctors whether to discontinue this medication prior to the procedure. These anticoagulant meds are usually prescribed to protect a patient against stroke, heart attack, or other vascular occlusion event. Therefore the decision to discontinue one of these medications is not made by the pain management physician but rather by the primary care or specialty physician (cardiologist) who prescribes and manages that medication. Examples of medications that could promote surgical bleeding include Coumadin, Plavix, Aggrenox, Pletal, Ticlid, and Lovenox.
What should I expect after the procedure?
Most patients will experience a mild to moderate increase in back pain after discography. This typically lasts for a day or two, and then the pain will return to baseline.