Discography by Dr. Vivek Loomba
Discography also called a “Discogram”, is a test performed to evaluate chronic pain in the spinal disc. It determines an abnormal spine in the body that results in severe back pain. A discogram procedure helps in identifying which disks need to be removed for a reduction in back pain. This procedure is helpful in patients where other procedures such as MRI scans have failed in diagnosing the pain issues. It allows doctors to see the internal structure of vertebrae to find the root cause of pain.
Around 80% of the population will experience back pain at some point in their life with regard to their age and lifestyle factors, and based on the research data it is also one of the fifth-leading reasons for a doctor’s visit.
How Discography procedure work?
A Fluoroscopy (x-ray imaging) will be used to insert needles in the spinal disc section. A dye is injected into the spine disc to make the disc’s structure visible on the screen. During this procedure, subsequent pain may arise in the back therefore, patients are given IV and local anesthetic for pain reduction. This helps the doctor to see damage on the disc whether it is torn, bulging, or leaking.
If the dye stays in the center of the disc, then the disc is normal. But if the dye starts spreading outside the center of the disc then the disc is experiencing pain and tear. It is one of the diagnostic procedures that only diagnose the source of pain so that, doctors can provide effective treatment options for pain relief in patients.
Before the Procedure
A certain sedative is given through the vein for a smooth pain-free procedure. A patient is usually awake during the discogram procedure when only the targeted area is numbed for a significant decrease in pain. A patient can also be provided an antibiotic for the prevention of an infection in the body.
After the Procedure
Doctors will keep you under observation in the diagnostic room for 30 to 60 minutes. However, you’ll experience some low back pain in the treated area for several hours and days. It is advisable to ice the area for 15 to 20 minutes for lowering the pain. Also, if the pain lasts longer than two weeks you should consult your doctor on significant side effects.
Discography Usage
It is performed to diagnose the cause of back pain and the treatment options for abnormal discs are determined through necessary evaluation. It helps in also finding the severity of back pain by examining the internal structure of vertebrae which is a major source of the pain. Discography is usually performed due to some necessary conditions such as –
- High Frequency of Spinal Pain
- High Frequency of MRI (Magnetic Resonance Imaging) findings
- Low chances of success in Surgery
- Assessing whether or not the spinal disc is causing the back pain
- Detailed images of tissues and organs such as lungs, bones, and blood vessels.
- Ability to image bone, soft tissue, and blood vessels at the same time
Discography is the best option when you have pain occurring in the intervertebral disc which is extensively caused due to herniation or deterioration. It is also performed before the surgery to determine the specific damaged disc for constructive treatment. MRI can also be used for the diagnostic procedure in the evaluation of the source of pain. But since MRI fails in examining unusual findings discography is the preferred choice among doctors for back pain testing.
Risk Factors
The risk factor can be determined on the basis of chronic pain and the medical health condition of a patient. The basic risks involved in discography procedures are –
- Skin infection from invasive and non-invasive procedures. It is determined on the basis of a diagnostic ratio of the procedure applied.
- An allergic reaction can occur if the procedure uses an injection of contrast material (internally administered substance).
- Excessive exposure to radiation can increase the chances of getting cancer.
- Pregnant women should stay away from this procedure.
- Mothers should avoid breastfeeding completely for 24 hours.
More complications or side effects involved in this procedure are –
- Headache
- Nausea
- Bleeding
- Nerve damage
- Paralysis
- Numbness or weakness
- Worsening back pain
- Blood vessel or nerves injury around the spine
- Infection due to injected discs
Limitations of Discography
Discography is not used for minor back pain as it can be treated with home treatments and prescribed medications. Discography is an invasive test that is recommended only if other options such as surgery, physical therapy, or pain medications fail. As the spinal disc can be damaged from wear and tear in the body that needs to be removed or treated after proper evaluation through advanced tests. For that, a combination of treatments needs to be adapted for better efficacy of the procedure.