An MRI often shows several worn discs, but not every worn disc hurts. When surgery such as a fusion or disc replacement is being considered for back pain, it matters a great deal to know which disc is actually causing the pain. A discogram is one way to find out.
A discogram, also called discography, is a test in which a thin needle is guided into one or more discs using X-ray. A small amount of contrast dye is injected into each disc. You stay awake and tell the doctor whether the pressure reproduces your usual pain. A CT scan is usually done afterward to show any tears inside the disc.
Discograms are performed by a pain specialist or radiologist. Several discs are usually tested, including at least one that looks healthy, for comparison.
A discogram helps show:
Dr. Grunch may order a discogram when she is considering a lumbar fusion or lumbar disc replacement for back pain and needs to confirm which levels to treat. In some cases, a noninvasive test called Nociscan may be used instead.
You lie on your stomach. You may get a mild relaxing medicine, but you will stay awake enough to answer questions. The skin is numbed and the needles are guided into the discs with X-ray. As dye is injected into each disc, you will be asked whether you feel pressure, pain, and whether the pain feels like your usual pain. The test takes about 30 to 60 minutes, followed by a CT scan.
Your back may be sore for a few days. Ice, rest and your usual pain medicine can help. Call the center or your doctor right away if you develop a fever, chills, or back pain that keeps getting worse over the following days, because these can be signs of a disc infection. Dr. Grunch or one of her physician assistants will review the results with you as part of your surgical plan.
Discograms are generally safe, but they are more invasive than imaging tests. Possible risks include a temporary increase in back pain, disc infection (discitis), bleeding, a headache, nerve irritation and a reaction to the dye. These risks are why discograms are used selectively, only when the answer will change your treatment.
An MRI shows which discs look worn, but not which ones actually hurt. A discogram tests each disc to see which one reproduces your usual pain.
It can be uncomfortable, and the goal is to see whether it reproduces your pain. The skin is numbed and the test is brief, and the pain from a painful disc usually settles quickly.
For some patients, Nociscan, a noninvasive MRI-based test, can help show which lumbar discs are likely painful without needles.
If Dr. Grunch has ordered a discogram for you and you have questions, call 470-293-9800 or contact us. You can also ask general questions any time through our “Ask Us Anything” chat. For questions about scheduling, cost or arrival time for the test itself, call the imaging center where it is booked.
Related: All imaging and diagnostic tests · Discogenic back pain · Nociscan
This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms and follow the instructions from your imaging center.
