FAQs on Lumbar Discogram in Colorado

 

A discogram is not a therapeutic procedure. Rather, it is a test used to determine if your neck or back pain is being cause by a damaged, weakened, or displaced disc. The procedure is used to assess for disc disease and is used to assess discogenic pain.

What are intervertebral discs?

Discs are cushioning quarter-sized structures made of cartilage and a watery gel substance. Discs are shock absorbers between the spine bones (vertebrae). Each vertebra has a disc above and below it, with the spine consisting of vertebrae, discs, the spinal cord, and spinal nerves.

What conditions require a discogram?

Disc-related pain occurs with disc disease. Conditions that may require you to have a discogram include:

  • Degenerative disc disease
  • Herniated disc
  • Bulging disc
  • Discogenic pain

What does the discogram show?

The discogram is used to determine which spinal discs are damaged, and if or not those discs are the source of your pain. This test will show if the disc has started to rupture, if the disc has tears of the tough outer layers (collectively called the annulus). When the doctor injects the disc, the pressure may cause pain, which alerts the doctor that the disc is problematic. The discogram does not show a herniated disc, nor does it show the nerves or bones of the spine.

How do I prepare for the discogram?

The doctor will review the pros and cons of the discogram procedure. You must understand the benefits and risks associated with the discogram before it is scheduled. The doctor will take a medical history, conduct a physical examination, and inquire about your discogenic pain. Because the procedure is minimally invasive, you will be given a sedative.

Avoid eating or drinking after midnight before your test, and notify the doctor of any medications you take. You should arrive an hour before your scheduled procedure, as certain laboratory tests may be required. Because you cannot drive after the procedure, arrange for someone to drive you home. Wear comfortable clothing, and leave all valuables at home.

What can I expect during the lumbar discogram?

An interventional radiologist will discuss the procedure, answer your questions, and have you sign a consent form. After you change into a procedure gown, the nurse will place an IV catheter in your arm. Once you are positioned face-down on the table, your back is cleaned with an antiseptic solution. The nurse administers a sedative in your IV, and monitors are used to assess blood pressure, heart rate, and oxygen level.

The doctor numbs the skin over the spine with a local anesthetic. Once numb, the physician inserts a needle with catheter into the center of the disc. Real-time x-ray is used to assure needle placement. A dye with antibiotic is also injected into the disc. During injections, the doctor will ask you questions about pain and what you feel. During the discogram, the doctor may choose to inject and test several discs. A typical discogram takes around 60 minutes.

What happens after the discogram test?

After the test, you are monitored in the recovery room for an hour. As the local anesthetic wears off, expect to have some mild soreness. The results of the discogram will be sent to your pain management specialist, if he is not the doctor who performs the test.

Does the discogram work?

In a recent clinical study, the discogram was considered successful for diagnosing discogenic pain. Adjusting for certain factors the predictive value of discography was calculated at 60%.

Resources

Carragee EJ, Lincoln

T, Parmar VS, & Alamin T (2006). A gold standard evaluation of the ‘discogenic pain’ diagnosis as determined by provocative discography. Spine, 31(18):2115-2123.

University of Maryland (2017). Discogram. Retrieved from: http://www.umm.edu/programs/spine/health/guides/discogram