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Provocative Discography

Discography (also called a Discogram) is a special X-ray test that allows the doctor to view the inside a particular disc or discs, and determine if it is the cause of your pain. The doctor will look for tears, scarring, bulges, and changes within the disc.

Procedure Overview

Discography is an outpatient procedure done in the Operating Room. When brought to the Operating Room, you will be connected to monitoring equipment (EKG monitor, blood pressure cuff, and a blood-oxygen monitoring device). The doctor or nurse will start an intravenous line and give some medicine to help you relax. You may also receive an antibiotic. If you are receiving a lumbar (low back) Discogram you will lie on your stomach. For a cervical Discogram (neck) you will lie on your back. After cleansing your skin with an antiseptic solution, the doctor will inject some numbing medicine that will produce a burning sensation for a few seconds.

After the numbing medicine takes effect, another needle is inserted through the skin, into the disc space. Although you will not feel any pain, you will feel a sense of pressure. With the assistance of a special X-ray machine called a fluoroscope, the doctor will inject a radiopaque dye (contrast solution) into your disc space. You will feel some pain, perhaps similar to the pain you have been experiencing. The doctor will ask you if this causes your usual pain or if it causes a different pain. The procedure may be repeated on as many discs as necessary. After the procedure, you will be asked to remain at the Clinic for a few hours before going home.

Procedure Details

Will you be asleep for the procedure? Since this is a procedure to diagnose, not a treat a problem, it is very important for you to be able to talk to the doctor and tell him the type of pain you are experiencing. You will receive enough medication to keep you comfortable but you will not go to sleep. How long will the procedure take? Normally, Discography takes from 30 minutes to an hour, depending on how many discs are injected.

Before the Procedure

Do not eat or drink anything after midnight the day before your test. If you are on medications, you may take them with sips of water. If you are a diabetic, discuss your medication with your doctor. You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over-the-counter medications you take, including herbal and vitamin supplements. The doctor will tell you if and when you need to discontinue the medications.

It is very important to tell the doctor if you have asthma, had an allergic reaction (i.e. hives, itchiness, difficulty breathing, any treatment which required hospitalization) to the injected dye for a previous radiology exam (CT scan, angiogram, etc) or if you have had an allergic reaction to shellfish (shrimp, scallops, lobster, crab). The doctor may prescribe some medications for you to take before having the procedure. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.

After the Procedure

Drink plenty of clear liquids after the procedure to help remove the dye from the kidneys.Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation. You may experience an increase in your usual pain including muscle soreness in your back where the needles were inserted. Use ice packs three or four times a day and take your usual pain medications. Do not apply heat or soak in water (i.e. tub, pool, jacuzzi, etc.) for the remainder of the day. Depending on how you feel, you may resume normal activities and return to work in one to three days.

Procedure Risks

The main risk, though it happens less than 1% of the time, is diskitis, an infection in the disk that can lead to an infection in the spine. You may experience what is called paresthesia. This is a shooting, "electric-shock" type pain that may occur when medicine is injected into the disk and more pressure is put on the nerve. Paresthesia usually passes quickly but on rare occasion, it continues. As with most procedures, there is a small risk of bleeding, infection, nerve injury, or allergic reaction to the medications used. If you experience severe back pain, new numbness, or weakness of your legs, a headache that will not go away or signs of infection in the area of the injection, you should call the doctor right away.