DISC STIMULATION TESTING
A discogram is a diagnostic test performed to view and assess the internal structure of a disc and determine if it is a source of pain. It is a diagnostic procedure, not a treatment. X-ray dye is injected into the spinal disc(s) and an x-ray (or a "discogram") is taken. The discogram may show tears (fissures) in the lining of the disc. The results of discography can be used to plan treatment options of your back pain including RF Anuloplasty (Disc-trode), IDET, Proliferate therapy, Percutaneous Decompression (Nucleoplasty) or spinal surgery .
Why should I have discography?
Discography will definitively determine if your pain is from a damaged disc. With age or injury, the wall of the spinal discs can become damaged (or fissured.) This condition is called Internal Disc Disruption or Degenerative Disc Disease. The wall of the disc can weaken and protrude out (a herniated disc). When the disc causes pain, it is typically a deep ache that sometimes radiates into the buttocks or thigh. Pain from facet joints in the back and from the sacroiliac (SI joints) can be difficult to distinguish from disc pain by history, exam or MRI alone. Discography is the best way to determine if your back pain is from a damaged disc.
How is it done?
You may be given medication to help you relax during the procedure. A local anesthetic is injected before a needle is inserted under fluoroscopic guidance into the disc. Contrast is injected, while careful monitoring of the flow pattern and your pain response is recorded. Rarely a CT scan is performed on the painful disc after the dye is injected to obtain further images of the dye distribution.
Will the procedure hurt?
The procedure involves inserting a needle through skin and deeper tissues, so there is some mild discomfort involved. However, your doctor will numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the examining the disc. If your disc is damaged, the dye injection may aggravate your typical pain pattern for a day or two. Ice and oral analgesics usually manage the pain adequately.
How long does it take?
Thirty to forty-five minutes depending on the amount of discs tested.
What should I do after the procedure?
We advise patients to take it easy the day after the procedure. You may need to apply ice to the affected area for 20-30 minutes at a time for the next day. You can then perform activities as tolerated. Your doctor will provide specific activity restrictions if indicated.
What are the risks and side effects of discography?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is discomfort, which is temporary. Sometimes, the discogram needle brushes past a nerve root and the nerve root is irritated. This pain gets better quickly. The other risks involve infection, bleeding, and worsening of symptoms. Fortunately, because the procedure is performed with X-ray in a controlled environment, serious side effects and complications are rare.
Who should not have this procedure?
If you are allergic to any of the medications to be injected, if you are on a blood thinning medication (e.g. Coumadin®, Plavix®), or if you have an active infection, you should not have the procedure.
A discogram is a diagnostic test performed to view and assess the internal structure of a disc and determine if it is a source of pain. It is a diagnostic procedure, not a treatment. X-ray dye is injected into the spinal disc(s) and an x-ray (or a "discogram") is taken. The discogram may show tears (fissures) in the lining of the disc. The results of discography can be used to plan treatment options of your back pain including RF Anuloplasty (Disc-trode), IDET, Proliferate therapy, Percutaneous Decompression (Nucleoplasty) or spinal surgery .
Why should I have discography?
Discography will definitively determine if your pain is from a damaged disc. With age or injury, the wall of the spinal discs can become damaged (or fissured.) This condition is called Internal Disc Disruption or Degenerative Disc Disease. The wall of the disc can weaken and protrude out (a herniated disc). When the disc causes pain, it is typically a deep ache that sometimes radiates into the buttocks or thigh. Pain from facet joints in the back and from the sacroiliac (SI joints) can be difficult to distinguish from disc pain by history, exam or MRI alone. Discography is the best way to determine if your back pain is from a damaged disc.
How is it done?
You may be given medication to help you relax during the procedure. A local anesthetic is injected before a needle is inserted under fluoroscopic guidance into the disc. Contrast is injected, while careful monitoring of the flow pattern and your pain response is recorded. Rarely a CT scan is performed on the painful disc after the dye is injected to obtain further images of the dye distribution.
Will the procedure hurt?
The procedure involves inserting a needle through skin and deeper tissues, so there is some mild discomfort involved. However, your doctor will numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the examining the disc. If your disc is damaged, the dye injection may aggravate your typical pain pattern for a day or two. Ice and oral analgesics usually manage the pain adequately.
How long does it take?
Thirty to forty-five minutes depending on the amount of discs tested.
What should I do after the procedure?
We advise patients to take it easy the day after the procedure. You may need to apply ice to the affected area for 20-30 minutes at a time for the next day. You can then perform activities as tolerated. Your doctor will provide specific activity restrictions if indicated.
What are the risks and side effects of discography?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is discomfort, which is temporary. Sometimes, the discogram needle brushes past a nerve root and the nerve root is irritated. This pain gets better quickly. The other risks involve infection, bleeding, and worsening of symptoms. Fortunately, because the procedure is performed with X-ray in a controlled environment, serious side effects and complications are rare.
Who should not have this procedure?
If you are allergic to any of the medications to be injected, if you are on a blood thinning medication (e.g. Coumadin®, Plavix®), or if you have an active infection, you should not have the procedure.
MANHATTAN
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