Are discograms really necessary?

Okay, first let me state that I am clearly a big chicken! I'm owning it. But seriously, with so much evidence out there questionong the validity of discograms, are they really necessary? What info can they definitively give you that you can't get from a good quality MRI?

I have a collapsed L5-S1, almost bone on bone. L4-L5 looks great, best disc I have. L3-L4 is dessicated and there is some loss of disc height but has been this way for 10 years and symptoms correlate with L5-S1. What more can be learned from this test? Also, for those who've had it, could you go back to work the next day?

Thanks for the input...

And yes, I'm scheduled for one, right now it's 50/50 that I'll show...

[ans]

http://www.chirogeek.com/000_Anular_Tear_1.htm

But: http://www.spine-health.com/topics/d...isc/lum01.html

It recreated pain in one of my discs along with sciatica.

But some say that that the discogram itself is invasive in a negative way - but I don't know the argument(s).

But I'm glad I did; at least I have some idea what the pain generator re: non-stop back pain's from. Then, there are other pain generators to check out too.

It is not my intention to confuse you. I too ask the same question. I also think a discogram can indicate annular, etc. tears that an MRI cannot.

Good luck, ans

I've had 2 discograms and both were very painful post op. I'm an accountant so my job is not physical and I could not sit up long enough to work the next day. Everyone's different, but if you can, I would stay home the next day. The test irritates the whole area, I find that resting and "laying low" helps you get back on your feet faster.

BTW during the test it is important to be clear about your responses. Make sure you tell the doctor if the pain is your normal pain, exactly where it hurts and how bad on a 0-10 scale. Read the report afterwards to make sure its correct. Also, many doctors will give you a steriod injection or equally pain relieving drug post op, request this, it really helps. Ask twice if you have to. Also, get a muscle relaxer like Zanaflex if you don't have one, everytime I have this test my muscles spaz out so it helps.

Good luck and remember to take deep breath when it hurts during the test, sometimes it can be pretty bad. Remember, the pain is moving you one step closer to getting better... so no pain, no gain.

Do the test. I've had it done 2x and got consistent results. When I switched pain mgmgt dr's, due to a move, I had to do the diskogram again because the new dr wanted to see for himself what level of pain I was in and if in fact both disks were problems for me. The 2nd time I had a CT scan right afterwards...and it was very helpful to confirm and subjective dx of the diskogram...and it seemed that it was the one thing my surgeons really focused on to confirm my need for surgery.

I found it strange that my early MRI's were really downplayed ..early primary care drs and neurologists and pain mgmt drs would say my disks only had slight bulges but nothing to "justify" my pain complaints. But after being insistent I really had these pains for a long time, I became a pin cushion for steroid injections and facet injections and then I finally was told I needed a diskogram. I almost didn't do it because I was frustrated to learn a diskogram was only a diagnostic test rather than something to help the pain. Luckily my trusty PT told me I should do it and Thank God she did that. IT was the first time I had test results that drs started believing my pain complaints!!!! Wish I would have had it done in the first 6 mos after my injury. Would have saved me a ton of frustration and fighting to find a real dx.

After my diskograms and ct scan, and when I finally was referred to a spine surgeon...the surgeon looked back at those early MRI's and said he could see where the problem was, especially in comparison to my diskograms and CT scan. ARGH! I have disk tears and my guess is that since my disk height is still decent it's not as obvious on the MRI even though they are much darker than the other disks. But no one mentioned the significance of darker disks until after i had the diskograms!

Your situation is a little different but nevertheless, the anticipation of pain should NOT deter you at all. The spike in pain is temporary. However, you should plan to take the rest of the day and next day off just in case. The real pain, for me, kicked in a couple hours after the diskograms and I needed vicodin to move or turn over while in bed for the next 12 hours or so.

[spotty14]

It wasn't until I got a discorgram that I found out that I had a tear in L2 as the MRI didn't show that.

[annapurna]

Dr. Yeung presented at a Mark Mitzner seminar and showed an MRI of three disks. Two were in terrible shape and the third was fully hydrated with no damage visible. The discogram showed that the pristine disk wasn't. It had a small unnoticed tear and was actually the main pain generator for the patient. Discograms are important diagnostic steps.

[bobb0]

If you proceed with surgical intervention and have less than satisfactory results, you may regret not having all the diagnostic tests that were available to you.

[Kim]

They also found things with my discogram that were not detected on my MRI's and found exactly which discs were the pain generators. It was very worthwile test for me to have. I was sedated and didnt feel or remember a whole lot about it afterwards so it was not a terrible ordeal like I had heard in the past. Now the myelogram I had bef4 my laminectomy was more uncomfortable because of the positions I had to get in to get the films done etc.
So yes I feel its a valuable diagnostic tool and wish they had done one on me earlier rather than other stuff.
But hindsight is 20/20 Hope this helps u make your decison.

[Kim]

Sorry didnt see your last question no I could not work the next day cause of the pressure from the dye stil in the painful areas. I was told i could go back in 3 days and I did. Worked one light day then was back to par for the course.

[biffnoble]

Hi:
A cervical ADR recipient has opined that her discogram caused her (pre-ADR) multilevel cervical disc breakdown to accelerate.

Interesting point.

The procedure does inject dye into the nucleus of the disc. One wonders.

She opined that "effective" nerve root blocks could accomplish the same thing and were less painful/invasive.