What is a Discogram? Purpose, Procedure & Results

A discogram is a specialized imaging test that helps doctors examine the health of your spinal discs. It's like getting a detailed map of what's happening inside the cushions between your vertebrae, especially when other tests haven't provided clear answers about your back pain.

This procedure combines X-ray imaging with a small injection of contrast dye directly into your spinal discs. Your doctor can then see exactly which discs might be causing your pain and how damaged they are. While it sounds intensive, discograms are performed by experienced specialists who prioritize your comfort and safety throughout the process.

What is a discogram?

A discogram is a diagnostic test that evaluates the internal structure of your spinal discs. Think of your spinal discs as jelly-filled cushions between your vertebrae that act as shock absorbers for your spine.

During this test, a radiologist injects a small amount of contrast dye directly into one or more discs in your spine. The dye shows up clearly on X-rays, revealing the internal structure of each disc. This helps your doctor see if a disc is torn, herniated, or otherwise damaged.

The procedure also involves monitoring your pain response during the injection. If injecting a particular disc reproduces your usual back pain, it suggests that disc is likely the source of your symptoms. This information becomes crucial for planning your treatment.

Why is a discogram done?

Your doctor might recommend a discogram when other imaging tests like MRI or CT scans haven't clearly identified the source of your chronic back pain. It's particularly helpful when you're considering spinal surgery and need to pinpoint exactly which discs are problematic.

This test becomes especially valuable when you have multiple disc abnormalities visible on other scans. Since not all disc changes cause pain, a discogram helps determine which ones are actually responsible for your symptoms. This precision prevents unnecessary surgery on healthy discs.

Discograms are also used to evaluate the success of previous spinal treatments. If you've had disc replacement or fusion surgery, this test can check how well the treatment worked and whether adjacent discs have developed problems.

What is the procedure for a discogram?

Your discogram takes place in a specialized radiology suite with advanced imaging equipment. You'll lie face down on an X-ray table, and the medical team will clean and numb the injection site on your back.

Using continuous X-ray guidance called fluoroscopy, your doctor will carefully insert a thin needle into the center of each disc being tested. This precision ensures the needle reaches exactly the right spot without damaging surrounding tissues.

Here's what happens during the actual procedure:

1. You'll receive local anesthetic to numb your skin and deeper tissues
2. The doctor inserts a thin needle through your back muscles into the disc
3. A small amount of contrast dye gets injected into the disc
4. X-ray images are taken to see how the dye spreads within the disc
5. You'll be asked to rate any pain you feel during each injection
6. The process repeats for each disc being examined

The entire procedure typically takes 30 to 60 minutes, depending on how many discs need evaluation. Most people can go home the same day after a brief observation period.

How to prepare for your discogram?

Your preparation starts about a week before the procedure when you'll need to stop taking certain medications. Blood thinners, anti-inflammatory drugs, and some pain medications can increase bleeding risk, so your doctor will provide a specific list of what to avoid.

On the day of your discogram, plan to arrive with a responsible adult who can drive you home afterward. The sedation and procedure effects make it unsafe for you to drive for the rest of the day.

You'll want to follow these important preparation steps:

• Don't eat or drink anything for 6-8 hours before the procedure
• Wear comfortable, loose-fitting clothes you can easily change out of
• Remove all jewelry, especially around your neck and back
• Bring a current list of all medications and supplements you take
• Arrange for someone to stay with you at home for the first 24 hours
• Plan to take the day off work and avoid strenuous activities

Your medical team will review your complete medical history and current symptoms before the procedure. This helps them target the right discs and understand what to expect during your test.

How to read your discogram results?

Your discogram results come in two parts: the visual images and your pain response during the procedure. The contrast dye creates detailed pictures that show the internal structure of each tested disc.

Normal, healthy discs contain the contrast dye within their center, creating a smooth, rounded appearance on X-rays. The dye stays contained within the disc's natural boundaries, and injecting it shouldn't reproduce your typical back pain.

Several findings might indicate disc problems:

• Contrast dye leaking outside the disc suggests tears in the outer wall
• Irregular dye patterns indicate internal disc damage or degeneration
• Reproduction of your usual pain during injection points to that disc as a pain source
• Abnormal pressure readings during injection can reveal disc health issues
• Complete absence of dye uptake might indicate severe disc degeneration

Your radiologist will combine these visual findings with your pain responses to create a comprehensive report. This information helps your doctor determine which discs are causing your symptoms and plan appropriate treatment.

What are the risk factors for needing a discogram?

Certain factors increase your likelihood of developing disc problems that might require discogram evaluation. Age plays a significant role, as disc degeneration naturally occurs over time, with most people showing some disc changes by age 40.

Your lifestyle and physical demands also influence disc health. Jobs requiring heavy lifting, prolonged sitting, or repetitive bending put extra stress on your spinal discs over time.

These factors commonly contribute to disc problems:

• Previous back injuries or trauma from accidents or falls
• Genetic predisposition to disc degeneration or spinal problems
• Obesity, which increases pressure on your spinal discs
• Smoking, which reduces blood flow to disc tissues
• Poor posture during work or daily activities
• Lack of regular exercise leading to weak core muscles
• Autoimmune conditions that affect connective tissues

Having these risk factors doesn't guarantee you'll need a discogram, but they do increase your chances of developing disc-related back pain that might require detailed evaluation.

What are the possible complications of a discogram?

Most people tolerate discograms well with only minor, temporary side effects. However, like any medical procedure involving needles and contrast dye, there are some risks to be aware of.

Common, mild complications that usually resolve within a few days include increased back pain at the injection site, headache, and muscle soreness. These typically respond well to rest and over-the-counter pain medications.

More serious but rare complications can occur, and it's important to know what to watch for:

• Infection at the injection site or within the disc space
• Allergic reaction to the contrast dye or medications used
• Nerve damage causing numbness or weakness in your legs
• Bleeding or bruising around the injection site
• Spinal fluid leak causing severe headaches
• Disc injury from the needle insertion

Your medical team takes extensive precautions to minimize these risks, including using sterile techniques and monitoring you closely during and after the procedure. Most complications, when they do occur, are treatable with appropriate medical care.

When should I see a doctor after my discogram?

You should contact your doctor immediately if you develop fever, severe headache, or signs of infection after your discogram. These symptoms could indicate serious complications that need prompt medical attention.

Some increased pain and stiffness is normal for the first few days after the procedure. However, certain symptoms warrant immediate medical evaluation and shouldn't be ignored.

Call your doctor right away if you experience:

• Fever over 101°F (38.3°C) or chills
• Severe headache that worsens when you sit or stand
• New numbness or weakness in your legs or feet
• Increasing redness, swelling, or drainage at injection sites
• Back pain that's much worse than before the procedure
• Difficulty controlling your bladder or bowels

For routine follow-up, schedule an appointment with your doctor within 1-2 weeks to discuss your results and next steps. This gives enough time for any procedure-related discomfort to subside while ensuring timely treatment planning.