Lumbar Discography
Discography is a test used to determine whether the intervertebral disc is the source of pain in patients with predominantly axial back (internal disc disruption syndrome). During the procedure, x-ray contrast (dye) is injected into the disc and the patient’s response to the injection is noted. If the test reproduces your typical, daily back, this suggests that the disc is likely the source of the pain.
A CT scan must be performed immediately after the discogram to better assess the anatomical changes in the disc. For the test to be valid, the CT scan must reveal contrast leaking into tears on the inside of the disc; thus demonstrating internal disc disruption.
Specific indications for discography include the following:
- Persistent, severe symptoms when other diagnostic tests have failed to clearly confirm a suspected disc as a source of the pain.
- Evaluation of recurrent pain from a previously operated disc.
- Assessment of patients in whom spine surgery has failed to provide relief.
- Assessment prior to spinal fusion surgery to identify symptomatic discs. Also, the surgeon may want to know whether the discs adjacent (next to) to the segment can support the stress of fusion.
- Assessment of candidates for minimally invasive procedures such as
Common complications associated with discography include: nausea (2%), headache (10%), and temporary increased pain (81%).
Rare complications include spinal headache, meningitis, discitis (disc infection), arachnoiditis (scarring), allergic reaction, seizure and serious bleeding.