Download DISCOGRAPHY - Winthrop Radiology Associates

A. Orlando Ortiz, MD, MBA, FACR
DISCOGRAPHY | A Patient Guide
Discography: What is it for?
A discogram has two purposes:
1. To diagnose and determine the cause of disc related (“discogenic”) back or neck pain
2. To identify the specific levels of disc- related back or neck pain
What is a Discography?
Discography is typically performed by a spine interventionalist under sterile conditions in a fluoroscopy suite. It involves the
careful placement of a fine-gauge needle through the skin (percutaneous) into the disc under X-ray guidance (fluoroscopy).
Once the needle is placed, the doctor will inject a small amount of liquid (usually iodine contrast agent) into the disc. In order to
make the test as objective as possible, you will not be told when the injection is taking place. The doctor may communicate with
you during the procedure, asking you questions about your pain and giving you instructions about important elements of the
procedure. It is critical that you remain completely still and follow the doctor’s instructions carefully.
What are the Risks?
Discography is a very safe procedure; complication rates much lower than 1% have been reported over the past 20 years. The
potential complications include bleeding (usually minimal), infection (discitis, abscess), inadvertent lumbar or cervical puncture,
headache, vasovagal reaction, vascular injury, and allergic reaction to the iodine contrast agent. If you have a question about
your specific risks or complications, discuss them with the doctor.
What Should I Do?
Before the Procedure:
Bring your MRI films to your appointment. The doctor will not be able to perform the procedure without them.
It is important that you are able to describe your pain, and to evaluate your pain on a scale of 1-10 (10 being the most severe
pain). The doctor may ask you about this before and during the procedure.
The night before your discogram, DO NOT have any thing to eat or drink after midnight. If you take daily medications, take
them with a small sip of water. DO NOT take pain medication on the day of you discogram. You will be given special instructions, for withholding specific medications (Coumadin, Plavix, Aspirin, NSAID’s, Fish oil, etc) that affect the blood’s clotting
capabilities, prior to the procedure.
Arrange for transportation home from the hospital following your discogram. Be prepared to invest about three hours of your
time in the Radiology Department, beginning at the time of your appointment; be sure to be on time, with your MRI films in
order to avoid having your procedure canceled.
During the Procedure:
The most important things you can do during the discogram are:
1. Follow the doctor’s instructions
2. Remain completely still
3. Communicate clearly with the doctor about the kind of pain you experience, distinguishing between your “typical” pain and
any other transient pain
4. You will need to lie flat on the procedure table for about 30 minutes. Depending on whether your disc pain is in your neck
(cervical or C-spine) or lower back (lumbar), you will need lie on your back (for cervical discography), or your stomach (for
lumbar discography).
5. The technologists and other assistants will help position you for the procedure.
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Following the Procedure:
1. You will be kept in the Radiology Department recovery area for observation for about an hour. You may take your medications
immediately following the procedure.
2. A CT scan will be performed after the discogram to provide the radiologist with more detailed imaging of the injected areas.
3. The CT study combined with the other information obtained during the discogram, will enable the radiologist to provide a
complete report to your doctor in order to help guide your course of treatment.
4. It is recommended that you rest until the next day; avoid strenuous activity, and give your body a chance to recover. Any
temporary pain from the discogram typically resolves within a few hours after the procedure.
What else should I Expect?
You may feel sore at the injection site(s) for up to a day or two after the procedure. This discomfort should gradually resolve and
will respond to your usual pain medication.
When will I Know the Results?
The radiologist will evaluate the results of the discogram and CT, and send a complete report to your doctor. You should expect to
discuss the results of the discogram with your doctor at your follow-up appointment.
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