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A discogram is a spinal study that can help to determine the source of low back pain in certain patient with degenerative disc disease. This test is typically performed in patients who are candidates for spinal fusion and the surgeon needs to determine which spinal level(s) to fuse. This is done by injection of fluid into the suspected disc(s) and if the patient experiences pain when the fluid is injected, then the disc(s) being examined may be the source or one of the sources of pain.
The patient will lie on a table on his/her side or in a sitting position. The radiologist will then use an x-ray to help guide a needle into the disc space of interest -- this may be done for more than one disc. An injection is then made into the disc and the patient is asked to describe their sensation of pain (or lack thereof). The findings are then correlated with other imaging modalities, such as magnetic resonance imaging (MRI), computed tomography (CT), and/or x-rays of the spine in order to determine the likely source of pain.
Discography uses ionizing radiations (x-rays) which while relatively harmless at low doses, can potentially increase the risk of certain types of cancers and other problems in chronic or repeated exposure. Furthermore, exposure to x-rays during pregnancy can increase the risk of birth defects. Therefore, all individuals, especially woman who are, or may be, pregnant, should carefully discuss this issue with their physician and radiologist before undergoing an discogram in order to weigh the benefits of the procedure against its potential risks.
In addition, since a needle will be inserted into the disc, there is a small risk of an infection which may require antibiotics or more intensive treatment.
Also, contrast agents that contain iodine are sometimes injected into the disc during this procedure. In rare instances, some patients may be allergic to these chemicals or may have a medical condition or be taking a medication which makes it dangerous to receive these agents. Therefore, patients should discuss their medical history, medications, and any other concerns with their physician and radiologist prior to the procedure.
