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Lumbar Discography
What is a Lumbar Discogram?
A lumbar discogram is a procedure that helps to diagnose back pain. It is a test to help determine if the disc is the pain generator. 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 your usual pain. If your pain is reproduced, that disc is most likely your 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 injected with a mix of X-ray dye and an antibiotic, you will be asked about what you feel. You may feel the following when the disc is injected:
- No pain
- A feeling of pressure
- A feeling of pain
If you feel pain, it's important to tell the doctor about the pain. One should label the pain as either:
- Familiar pain: The usual response is, “Ouch, that's my pain.”
- Unfamiliar pain: The usual response is, “Ouch, I've never felt that pain before.”
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 of the procedure?
As with any invasive procedure there are 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 do I do before the injection?
Patients must not eat or drink for 6 hours prior to the injection. All anti-inflammatory medications (ibuprofen, naproxen, NSAIDS) must be stopped for 3 days prior to the injection. If you are on any blood thinners (aspirin, coumadin, warfarin, heparin, plavix, aggrenox, lovenox), the physician or nurse must be notified prior to the injection. Please alert the physician or nurse if you have any allergies to X-ray dye. Please bring any films, X-rays, MRI scans or CT-scans with you on the day of the injection. All patients must have someone to drive them home.
What can I expect afterwards?
Most patients go home about 20-30 minutes after their injection. 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 for 7-10 days after the injection. The results of the test will discussed at that time.
