The Procedure
A discogram is a study in which radiographic dye is injected into the disk space. It images the anatomy of the disk space and shows when dye leaks through the annulus fibrosis. When the physician injects dye into the disk space, the patient reports (pain scale, 1 –10) how much pain has been produced. If the pressure injection of dye into the disk space reproduces the patient’s usual low back pain (called concordant), then the pain is thought to be “discogenic.” This possible result, in conjunction with the doctors other findings, usually validates the surgeon’s opinion regarding the most appropriate surgical correction. These remedies could include: artificial disc replacement, fusion, discectomy, etc.
Reality Check
Everyone dreads the idea of a future discogram appointment. But for many, the fear is worse than the appointment. Here’s a few things to keep in mind:
- It is a diagnostic procedure, often yielding useful information, such as as the previously mentioned “concordant” pain. This means that the pain corresponds to your actual pain locations (directly, as noted by your complaints) or by your pain dermatomes (affected areas). Also, some clinics will save the radiographic image of the dye-injected discs for the surgeon (although many do not). Either way, the doctor (often a pain mgt doc) will record notes of the procedure, later given to your spine surgeon.
- Most clinics will give you some kind of medication to help you relax before the procedure (dilotid is a good one!). Some will inject lidocaine during the procedure, which has a numbing and pain-relieving effect which can last for days.
- It’s not going to kill you (unless you have a really, really bad doctor!). What may help you is to read the experiences of others who have had the same “pleasure” as you! Read through some of these past discussions; but note that all patients' experiences are not "comfortable!"
Good overviews with more information:
http://www.spineuniversity.com/publi...esub.asp?id=79
http://www.spine.org/fsp/troubleshoo...iscography.cfm
http://www.spine-health.com/Topics/diag/diag08.html