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Discography involves the injection of contrast dye into the center of a disc under direct x-ray control. It is strictly a diagnostic procedure which helps the physician try to locate the source of your pain. Your skin will be injected with a numbing medication such as Lidocaine or Marcaine during the procedure. This may feel like a burning sensation in your back. The physician will tell you when they plan to start the injection(s). You will be asked to report how the injections feel. The most important thing is to report to the physician if the injection reproduces your usual pain.
WHAT IS THE PURPOSE OF DISCOGRAPHY?
Discography is used to determine whether or not pain is coming from a disc as well as identifying abnormalities in the disc. Some of the abnormal findings during the discography include the presence of a disc herniation, tear of the disc, or a fissure. These abnormalities can be directly viewed by the physician during the exam.
WHICH PATIENTS ARE CANDIDATES FOR DISCOGRAPHY?
If you have had treatments or therapies that have failed to relieve your pain, you physician may order a discography study. Typically, patients with discogenic pain experience pain with sitting and forward bending. However, it should be kept in mind that the symptoms are not specific and you may have other symptoms such as pain with extension or rotation of the back.
WILL THE DISCOGRAM BE PAINFUL?
Discography is only briefly painful. A local anesthetic will be used to numb the skin. The purpose of the exam is to reproduce your current pain at the specific location in your back where it occurs. This induced pain will subside after a few minutes. Areas which do not have abnormalities will not cause pain.
WHAT ARE THE RISKS OR SIDE EFFECTS ASSOCIATED WITH DISCOGRAPHY?
The associated risks involved with the injection(s) are bleeding, infection, and damage to the nerve. The procedure is performed under sterile conditions with the use of direct x-ray guidance which minimize the possible risk. During the procedure you will be given an antibiotic to reduce the chance of infection. You will be asked to report any signs of infection such as redness, swelling, fever and drainage at the injection site. You should have a thermometer at your home to monitor your temperature.
WHAT IF DISCOGRAPHY DOES NOT REPRODUCE MY PAIN OR DOES NOT ELICIT ANY PAIN DURING INJECTION OF THE DISK?
This indicates that the pain is not likely coming from the disk. The reproduction of pain is the single most important factor in determining whether a subsequent intervention (such as the intra-discal electrothermal therapy –IDET, or surgery) on a disk will be successful in reducing the patient’s pain. In the event that the discogram does not reproduce pain, consideration should be made for other diagnostic interventions.
IF YOU ARE ALLERGIC TO IV DYE YOU SHOULD REPORT THIS TO YOUR PHYSICIAN