Discography, also called a discogram is a diagnostic procedure used to determine if one or more discs is the source of cause of your back pain. If you have chronic back pain, you may need a discography.
What is a discography procedure?
Discography is an interventional diagnostic imaging test that is used to determine whether a specific intervertebral disc or a collection of intervertebral discs may be the source of your back pain.
The intervertebral discs are sponge-like cushions between the vertebrae of your spine. They act as shock absorbers for the spine and help provide flexibility to your spine and back.
When the intervertebral discs bulges or rupture, they may press on the nearby nerves of the spine. This can cause back pain.
During a discography, a contrast liquid is injected into the center of one or more intervertebral discs using x-ray guidance. Your doctor is able to see the area where the contrast liquid is injected more clearly. This injection may temporarily increase your back pain for your doctor to know the disc or discs responsible for the pain. Your doctor views the disc using x-ray or CT scan.
What is a provocative discography?
Provocative discography is an invasive diagnostic procedure whereby a needle and contrast dye is placed into a lumbar or cervical disc to identify if there is an internal disc disruption. If the contrast dye injected provoked your pain, it could mean a disc is causing your pain. Provocative discography is performed to determine which disc in their lower back in causing pain.
How is a discography done?
In preparation for a discography, you may need to avoid taking blood-thinners for some time before the procedure. You may also need to avoid food or drink the morning before the procedure.
You will be awake throughout the procedure. You may be sedated intravenously to help you relax throughout the procedure. Your doctor may also give you an antibiotic to help prevent infection.
You will be asked to lie on a table on your abdomen or side. Your doctor will thoroughly clean your skin. A numbing agent may be applied to reduce pain caused by the insertion of the discogram needle.
Your doctor will then insert the discogram needle and use an imaging technique (fluoroscopy) to watch as the needle enters your body. Fluoroscopy ensures that the needle enters into the right position. Your doctor will then inject a contrast dye (liquid) into the disk. The contrast dye helps your doctor to see the disc more clearly. Your doctor then uses X-ray or CT scan to see if the dye spreads.
If the dye remains in the center of the disk, this means that the disk is normal, but if the dye spreads outside the center of the disk, it means that the disk has undergone some wear-and-tears. These wears-and-tears may or may not be the cause of your back pain.
Also, if a disk is the cause of your back pain, you will feel increased pain during the injection of the dye. If a disk is not the cause of your back pain, you may not feel any pain or you may feel just a little pain during the injection of the contrast dye.
What should I expect after a Discogram?
After a discogram, you will remain in the procedure room for about 30 to 60 minutes for observations.
You’ll be able to go back home after observations. You shouldn’t drive back home by yourself. You’ll need someone to drive you back home.
You may feel some pain at the injection site or in your lower back for several hours after the procedure. You can apply an ice pack to the area for 20 minutes at a time to relieve the pain. Keep your back dry for 24 hours.
If you develop severe back pain, fever, or any other complications one to two weeks after the procedure, seek medical attention or call your doctor.
Discogram does not relieve back pain, your doctor only uses it to determine the cause of your back pain and decide on the best treatment for you.
What does a positive Discogram mean?
A positive discogram means that a disc is the source of your back pain. When the contrast dye is injected and you feel increased pain or the dye spreads outside the center of the disc, it means that the disc is the source of your pain. This is known as a positive discogram. If the reverse is the case and the disc is not the source of your pain, it is known as negative discogram.
How much does a discography cost?
The cost of a discography varies depending on the location and provider. A discogram usually has two costs. The first cost is the fee for the actual test, also known as the technical fee. The second cost is the fee of having a radiologist or a spine surgeon, read and interpret the test, also known as the professional fee. You may get the technical bill for the actual test from the hospital or clinic where you had the discogram done while you get the professional bill from the specialist who read and interprets the test. The total cost can range from $1,500 to 6,500 or more. Consult with your doctor to know the exact cost before undergoing the procedure.