Discography is used as a diagnostic tool in patients with persistent lower back, hip and/or leg pain, when traditional diagnostic tests (CT and MRI scans or myelograms) have failed to delineate a cause of the pain. It is used to differentiate between old scar tissue and recurrent disc herniation. It may also be helpful to determine if bulging discs are causing your pain.

Prior to the injections, an intravenous line (IV) will be started, and you will be placed on a monitor that will check your blood pressure and heart rate. You will be asked to lie on your stomach supported by pillows. Patients are usually given small amounts of sedation before going further. You should experience reduced anxiety and pain with partial or total amnesia. You will also be administered an antibiotic to decrease any risk of infection. A radiology technologist will use an X-ray machine to locate the discs of the spine to be injected. Your back will be cleaned with a special solution and draped with sterile drapes. The doctor will then use local anesthetic to numb the skin on your back at the level of each disc to be injected.

Once numbed, the doctor will advance a needle into the center of the disc to be injected. A small amount of X-ray dye is injected into the disc. If the injection reproduces your neck or arm pain, the disc is positive. If no pain occurs, that disc is probably not causing your pain. A small amount of local anesthetic will be injected in the disc after the dye. Another positive sign is, if the local anesthetic eliminates your pain. After all of the discs are injected, you will be taken to the CT scanner, and a scan of the discs will be done to look for other disc abnormalities. When finished, you will return to the recovery room for about 30 minutes before leaving for home. You will receive additional pain medication, if needed.

• It is possible that this procedure may make your pain worse or result in residual pain.
• Very small risk of bleeding or infection at the injection sites.
• Very small risk of infection in the disc itself. Should this occur, surgery would be required to remove the abscess. IV antibiotics are given to prevent his complication.
• It is possible for local anesthetic to leak out of the disc and cause an epidural block. We guard against this by using only very small amounts of local anesthetic.
• In rare cases, anatomic abnormalities may lead to injury of spinal nerve roots or of the spinal cord resulting in paralysis or partial muscle weakness or persistent numbness. We decrease this risk by using the X-ray machine and extreme caution when placing the needles.
• Rarely, reactions to the anesthetic drugs can cause flushing, ringing in your ears, or in very rare instances, seizures or respiratory depression.
• Allergic reactions to medications may cause your heart and breathing to stop or cause death.

• Normally, few side effects are experienced.
• If the test has been positive, you will experience stiff back and increased pain for several days. The pain will subside gradually.
• If severe pain, numbness or weakness continues or becomes worse, please call The Pain Treatment Center on the on-call doctor.

Discography will not relieve your pain, but it will give us information as to what may be causing your pain. If the discogram is positive, we may refer you for a surgical evaluation. If negative conservative therapy is indicated, we will continue to work to bring your pain to a tolerable level. At all times, we will share all of the information with you so that you may share in the decision making process.