Lumbar discography is a procedure used to determine if back pain is caused by one or more lumbar discs. It is usually done when the patient has failed other conservative treatments, and is considering surgery to treat their back pain. The test provides information for surgical planning.
How Does it Work?
By injecting the disc with fluid (usually a mix of X-ray dye and an antibiotic), the disc becomes pressurized. The pressurized disc can cause pain, which may or may not be the patient’s usual pain. If pain is reproduced, that disc may be the pain generator.
How Is It Done?
After the patient is given some slight sedation and the skin and underlying tissue is anesthetized, a needle is directed into the lumbar disc under X-ray guidance. A separate needle will be used for each disc that is tested. As each disc is pressurized, patients feel either pressure or pain. If pain is felt, it is important for patients to compare it to the pain they have been experiencing. If it is the same, this may indicate a diseased disc that is causing pain. After each disc is tested in this manner, the needles will be removed and the patient is taken to the recovery room.
What Are The Risks?
As with any invasive procedure lumbar discography has some associated risks and complications. The most serious complication is infection of the disc space, which is usually treated with IV antibiotics. Fortunately this complication is rare due to the strict sterile protocol that is followed for this procedure. Also, patients are given IV antibiotics prior to the injection, and antibiotics are injected into the disc to prevent infection. There is also a remote risk of nerve root injury and spinal headache, which is reduced by using X-ray for the procedure.
What Can I Expect After?
Most patients go home about 20-30 minutes after a lumbar discography procedure. Most patients will have some soreness in the back over the next 2-3 days. Using ice and over the counter anti-inflammatory medications will help with the soreness. Patients are advised to rest on the day of the injection, but may return to their normal activities the next day. Patients should make a follow-up appointment after the injection. The results of the test will discussed at that time.