Discograms

When doctors suspect that there is a problem with a disc, but the abnormality is hard to see on MRI's, CAT scans, and EMG's, a discogram may be recommended.  Discograms test the back differently than all of the other tests.  The actual pictures are not as important as the patient's pain during the test.  If the discogram can reproduce a patient's normal pain at just one or two discs, those are called "pain generators." 

Imagine if you had a sore arm.  You might poke around until you found the most tender part.  That part is usually the area causing the pain.  A discogram is similar.  One stresses each by injecting liquid to see if distending the disc (filling the disc with fluid under pressure) causes one's normal back pain.  If it does, we believe that removing that disc may alleviate the pain.

Discograms are usually done prior to surgery.  They are used to figure out if a surgery is likely to fix back pain.

Discograms can be done on low back or on the neck.

How discograms are performed

Discograms involve injecting a sterile saline solution into the disc space of the back. The entire procedure usually takes anywhere from thirty minutes to an hour to complete.

Before the procedure, you will have an intravenous (IV) catheter placed in your arm or hand. This IV will provide you with fluid and medication that may make you feel a little drowsy. Cervical discogram patients will lie on their backs, while other discogram patients lie on their stomachs.

You will receive a local anesthetic before a small needle is inserted in your back. Once the needle is in the correct position, sterile saline (with radiologic dye) will be injected into the area of the disc(s), and your pain response will be recorded.  X-rays will be taken during this period and damaged disc tissues will be visible in these x-rays.

Once your discogram is complete, you will need to stay still for an additional 30 minutes. You should limit your activity for the rest of the day and have someone drive your home. You can usually resume normal activity the day after your procedure.

If you are taking any blood thinners such as Coumadin and Plavix, you must stop taking them a week before your discogram procedure. Tell your primary care doctor and your neurologist before you stop taking your blood thinners.

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