Lumbar Discogram

A discogram is a diagnostic procedure where contrast material (x-ray dye) is injected into one or more chronic failed back painintervertebral discs of the spine. After the injection of the contrast dye, an x-ray is taken of the discs to evaluate for fissures, tears, crevices, or other disc damage. The results of this test can be used in the patient’s plan of care.

What is the purpose of a lumbar discogram?

A lumbar discogram is usually performed to find if low back pain is related to a damaged or degenerated disc, and to locate which disc(s) is/are causing the pain. The lumbar discogram is not a treatment, but the findings will allow the doctor to determine which therapy measure is best for you.

How do I know if my pain is related to disc damage/degeneration?

With age and/or injury, the wall of the spinal disc can tear, crack, or develop fissures, which is called internal disc disruption or degenerative disc disease. With this condition, the wall of the disc often weakens and bulges out of normal alignment, which is considered to be a herniated disc.

Lumbar disc pain is described as a deep, aching pain of the back. When the disc compresses nerves, it can cause pain in the buttocks, thighs, and legs. Because pain from other back structures can cause pain in the lumbar region, the discogram is the best procedure to determine if the pain is related to a damaged or degenerated disc.

How is a discogram performed?

The lumbar discogram procedure is performed using fluoroscopic (x-ray) guidance. Before the procedure, you will sign a consent form and receive intravenous antibiotics. To keep you comfortable and relaxed, a sedative is also given.

The patient is positioned on his/her stomach, and the low back area is cleansed with an antiseptic. A needle is passed into the disc and x-ray dye is injected with varying amounts of pressure.

The doctor will ask you several questions during the injection, which are related to your sdiscogramymptoms. Once the x-rays are taken, the needle(s) is/are removed and a dressing is applied.

How does the discogram feel?

When a normal disc is injected, it does not cause pain but does produce a sense of pressure. However, when an abnormal disc is injected, it can result in mild pain. Be sure to tell the doctor when you feel pain.

The doctor will ask you questions regarding your pain, as he/she injects the contrast material. Because the discogram involves inserting a needle through the skin, there will be some pain involved.

However, the doctor numbs the skin with a local anesthetic using a fine needle before inserting the needle into the disc. Additionally, the IV sedation makes the procedure well-tolerated.

How many discs are injected?

3 level discogramDepending on the findings from your physical examination and diagnostic imaging tests, the doctor will have an idea of which discs are causing the low back pain. Usually, between 1 to 4 discs are injected during a lumbar discogram.

What can I expect after the lumbar discogram?

The pain of the back condition will not improve after the procedure, as the discogram is a diagnostic test that allows the doctor to diagnose and confirm the cause of pain. You may experience a flare-up of back pain following the injection, but this gets better within 24 to 48 hours.

You will be advised of oral pain medication to take, as well as use of ice packs to the back. You will need a ride home, because driving is not permitted following the discogram. You will be asked to perform only activities that are necessary and tolerable for 2 to 3 days.

What are the risks and side effects of a discogram?

Usually, the lumbar discogram is a safe, purposeful procedure. However, as with other minimally invasive procedures, there are some risks and side effects, such as pain at the injection site, infection, bleeding, and worsening back pain.

Who should not have a lumbar discogram?

Any patient who is allergic to contrast dye should not have a discogram. Also, the discogram will not be done on people who are on blood thinners, have an active infection, or those with poorly controlled blood pressure or diabetes.