FAQ’s on Lumbar Discogram in Philadelphia

The discogram is a special spinal test used to diagnose the source of lumbar (lower back) pain. The lumbar discogram involves a technique that stresses the intervertebral disc to determine if or not it is damaged and causing pain.

What is an intervertebral disc?

A disc is a unique structure that cushions between aligning vertebrae. The discs bear the weight of the spine and allow for proper movement. The center of the disc (nucleus) is a gel-like material, and the outer layer is the annulus, which is composed of tough, fibrous layers.

Does the lumbar discogram hurt?

The lumbar discogram is a provocative test, which reproduces the pain while you are awake. The pain is mild, much like the typical disc pain the patient has during everyday activities. An anesthetic is used to numb the skin and deeper tissues, so you may feel a pinch and slight burning.

What causes disc-related pain?

Disc pain is often called discogenic pain. This is caused from irritation of the pain receptors in response to a torn annulus or compressed vertebra. The lumbar discogram is used as a pressure test to assess the disc structure.

What conditions are diagnosed with the discogram procedure?

Any problem of the spine can be diagnosed with a discogram. These include:

Degenerative disc disease occurs from aging and damage of the intervertebral discs. Bulging discs occur when the disc moves out of place and irritate nerves. A herniated disc occurs when the inner nucleus protrudes through the outer layer of the disc. These conditions result in discogenic back pain.

What happens before the lumbar discogram?

When you arrive at the outpatient center, a nurse will go over risks and benefits and have you sign a consent form. The nurse will place an IV in your arm to administer sedatives and fluids as necessary. Monitoring devices are used to assess blood pressure, oxygen level, and pulse rate.

How is the discogram performed?

This test involves examining the morphology of the disc to see what it looks like. The doctor first cleanses the skin with an antiseptic after positioning the patient on his/her stomach. The skin and tissues are injected with a local anesthetic, and the needle is guided into the disc using fluoroscopy (x-ray guidance). When contrast fluid is injected, along with antibiotics, he will ask questions about your pain and take pictures of the disc. Disruption of the disc wall and small tears will show up using special x-rays.

What risks and complications are associated with the lumbar discogram?

All minimally invasive procedures carry some risks. The risks include injury to nerves, worsening of back pain, intense pain, need for prolonged antibiotics due to discitus, and allergic reaction to medications and contrast dye.

Are the lumbar discogram results accurate?

The lumbar discogram is an accurate test for diagnosing degenerative disc disease and other disorders, according to the U.S. Preventive Services Task Force. A large review of research studies found that quality evidence supported the use of this test for diagnosing disc disease.

How does the doctor know if or not the discogram is successful?

Normal discs will be slightly painful during the discogram when pressure is applied through the injection. With damaged discs, the pain is worse, so the doctor will know exactly which ones are damaged or injured.

 

Resources

Manchikanti L, Glaser SE, Wolfer L et al. (2009). Systematic review of lumbar discography as a diagnostic test for chronic low back pain. Pain Physician, 12(3): 541-559.

Mayo Clinic (2014). Discogram. Retrieved from: http://www.mayoclinic.org/tests-procedures/discogram/basics/definition/prc-20013848