Discography / Provocative Discography
A discogram is a diagnostic test that is performed to evaluate the internal structure of a disc and to determine if it is a source of pain. To minimize risk of infection, prior to the procedure an IV will be placed and antibiotic medication given. During the procedure IV medication may be administered as a relaxant and pain reliever, however it is important for patients to remain awake during the procedure to tell the doctor what they are feeling.
Using x-ray guidance and after the skin and tissues have been numbed with local anesthetic, needles will be positioned into the discs being tested. X-ray dye will be injected into each disc, one at a time. The pressure of the dye fluid entering the disc simulates the pressure it is exposed to with routine activity. At the same time, an X-ray picture of the inside of the disc can be seen. If the disc is causing typical pain, the pressure of the injection will reproduce that pain, and at the same time, any structural abnormality is revealed in the X-ray image. In this manner, it can be determined which disc or discs are causing pain, and how that relates to any degenerative changes or disruption that is observed in the X-ray images or pictures.
During the examination patients will be asked questions such as:
- Is this causing you any pain?
- If you are having pain, is it like your typical back pain?
- You will be asked to rate the intensity of your pain using a pain scale from zero to ten:
- Zero = no pain, Ten = worst possible pain imaginable.
After the testing is completed, if patients are uncomfortable, pain medication may be administered through the IV. It is not uncommon for back or neck pain to increase for a few days following a discogram. A follow up appointment will be made to discuss test results.