DIAGNOSTIC TEST
A Discogram (also called discography) is a powerful diagnostic test used to pinpoint the exact source of back pain. While MRIs show disc *anatomy* (like a bulge or tear), a discogram determines if that specific disc is the *actual* generator of your pain. It is an essential tool for accurately planning further treatment, such as a spinal fusion.
PROCEDURE DETAILS
You will be given IV sedation to stay relaxed, but you must be awake enough to talk to your doctor. Using live X-ray (fluoroscopy), your doctor will guide a thin needle into the center of the first target disc.
A small amount of contrast dye is slowly injected into the disc. This pressurizes the disc. Your doctor will ask you what you are feeling. The key is to determine if the injection **recreates your "familiar" back pain**. This is called a "concordant" pain response.
The doctor may also inject a "control" disc (a healthy disc nearby) to ensure you can tell the difference. A healthy disc will feel pressure, but not pain. The process is then repeated for any other suspected discs. A CT scan is often taken afterward to see the dye pattern.
TEST ADVANTAGES
A discogram is the only test that can confirm *which* disc is painful, which is critical before considering surgery like a spinal fusion.
This is the primary benefit. It goes beyond imaging to functionally test the disc and confirm the exact source of your pain.
Many people have "abnormal" discs on an MRI but no pain. This test confirms if the disc seen on your MRI is truly the problem.
A positive discogram gives your surgeon confidence to proceed with a procedure like spinal fusion, knowing they are treating the correct level.
If a discogram is negative (it doesn't recreate your pain), it can prevent you from having a major surgery on the wrong disc.
The post-procedure CT scan provides a detailed map of any tears or fissures within the disc wall (the annulus) that an MRI might miss.
It is an active test. Your real-time feedback ("Yes, that's my exact pain!") is what makes the test so accurate and valuable.
IMPORTANT INFORMATION
A discogram is an invasive diagnostic procedure. While generally safe, it carries risks that are important to understand. The primary risk is discitis, which is why antibiotics are given.
Important: You will be given antibiotics before the procedure to minimize the risk of discitis. It is crucial to report any post-procedure fever, chills, or severe, worsening pain to your doctor immediately.
PREPARATION GUIDE
Preparation is vital for this test, especially regarding medications and allergies.
You must inform your doctor of any allergies, especially to shellfish, iodine, or contrast dye.
Stop blood thinners (Aspirin, Plavix, etc.) as instructed. You will also be given a prescription for antibiotics to take before the test.
Do not eat or drink after midnight. You must have a responsible adult drive you home due to the sedation.
The test relies on your feedback. Be prepared to communicate clearly with your doctor about the pain you feel.
RECOVERY GUIDE
Recovery is very quick, but you should expect some soreness from the procedure itself.
You'll be monitored for 1-2 hours as the sedation wears off. You will be discharged and sent home the same day.
It is common to have increased back pain or soreness at the injection sites. This is normal. Use ice packs and rest. Avoid strenuous activity.
The soreness from the procedure should be fading. You can gradually return to your normal daily activities as comfort allows.
You will have a follow-up appointment to discuss the results of the discogram and what they mean for your treatment plan.
Please don't hesitate to reach out and request an appointment. We look forward to meeting with you, addressing your concerns, and working together to enhance your quality of life.