Discography (Discogram)

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Discography is a specific test to tell if a damaged or abnormal disc is causing pain.  This is not a routine test.  It may be performed prior spinal disc surgery to determine which disc levels will be treated.

Preparing for discography

Discography is a medical procedure that often involves mild sedation. The patient is awake and responsive but will be given medication to help relax. There may be restrictions on food and medicine intake on the day before and the day of the test, which should be discussed with the physician’s staff. On the day of the test, the patient reports to the clinic. Although this is usually done as an outpatient procedure, another person should accompany the patient to drive home.

How is discography performed?

Discography, an invasive procedure, is performed under fluoroscopy (similar to x-ray, except in real time) in a sterile environment. The patient is dressed in a hospital gown. An intravenous line is placed through which a relaxing medication and antibiotics are administered. Patients are awake during the procedure, and the physician or someone on his or her team may ask the patient about symptoms during the test.

The patient is positioned on a surgical table, with pillows or cushions to provide support and comfort. The injection sites are cleaned with an antiseptic and the skin numbed using a local anesthetic.

Under fluoroscopic guidance, a contrast agent (dye) is injected into the center of selected discs. The contrast enhances the disc’s anatomical characteristics and may spread outside the disc if abnormal. As each disc is injected, the patient is asked about symptoms. If this test can reproduce the same symptoms of back pain, it is called a positive discogram.  If symptoms are not replicated, it is a negative discogram.  Discography can be uncomfortable, because it may cause painful symptoms to occur. These symptoms are temporary, and patients who experience intense symptoms should report them to the medical team.

The procedure usually takes under an hour, although this may vary depending on how many discs are examined.

What happens after the test?

Depending on the discogram test results, a CT scan may be ordered to provide the physician with additional information about the spinal disorder. Most patients are asked to remain at the clinic for a brief observation period. The results of the discogram will guide further treatment.