A discogram is an X-ray procedure that deliberately provokes the patient’s pain symptoms in order to pinpoint its source in the intervertebral disks. The procedure is designed to create a pain “road map,” making the discogram an excellent fusion surgery planning tool.

Discography is reserved for patients who have not responded to medications and conservative treatments, such as bed rest, traction or physical therapy, and for whom the possibility of lumbar (lower back) surgery is being considered. Discograms can also be used to detect problems within intervertebral disks that appeared normal on the CT or MRI scan.

During the procedure—what to expect

• You will lie on your stomach for lumbar and thoracic procedures and on your back for cervical procedures
• Using X-ray guidance (fluoroscopy), a anesthesiologist will place a thin needle into the center of your disk(s) thought to be causing your pain
• Contrast is then injected and X-rays are taken
• During and immediately following the procedure, you will be asked to describe what you are feeling (i.e., does it reproduce your symptoms). A discogram reveals the exact source of your disk pain by awakening the pain symptom in that disk
• When a healthy disk is injected, you will feel little or no pain. If the disk is not healthy, your pain may intensify
• As soon as that symptom has been recorded, the anesthesiologist will put the disk to sleep with a local anesthetic (numbing medication)
• You will remain awake during your procedure, which takes approximately 15–40 minutes
• In selected cases, a CT exam will follow, depending on the findings of your study and any prior imaging you may have had

After the procedure—what to expect

• Some degree of discomfort during and after this procedure is expected
• Limit your “stress-bearing” or “strenuous” activities for 24 hours due to expected post-procedure discomfort
• We recommend taking the following day off of work, but the decision to return to work is at your discretion
• A prescription for post-procedural pain medication is available for patients who require it

Possible side effects

• Steroid medications may cause facial flushing, occasional low-grade fevers, hiccups, insomnia, headaches, water retention, increased appetite, increased heart rate, and abdominal cramping or bloating.
• These side effects are bothersome in only about 5 percent of patients and commonly disappear within one to three days after the injection.