Discography

Description

Discography (also called a discogram) is a nonsurgical, diagnostic procedure used to determine if a disc is causing back pain. Discs are sponge-like cushions located between the bones of the spine. Discs act as a shock absorber for the spine and provide flexibility to the overall structure. When a disc ruptures, it may press on the nerve of the spinal column, causing pain and weakness.

During a discogram, a contract liquid is injected into the center of a disc using x-ray guidance. The injection consists of a dye, as well as antibiotics to prevent infection, and may temporarily induce back pain in the patient. The procedure lasts 30 to 45 minutes. After injection, the patient’s response is carefully noted. If the patient experiences pain after injection, then the disc may be the source of back and/or neck pain.

Discography involves the following mechanisms of action, which may lead to pain in an abnormal disc:

  • Increases intradiscal pressure

  • Biochemical or neurochemical stimulation

  • Increased pressure at the end plates

  • Transfer of pressure to an abnormal disc

Indications

A discogram should only be performed if conservative therapy and noninvasive diagnostic procedures, such as MRI, fail to reveal the source of back pain. Indications for a discogram include the following:

  • Persistent and severe pain

  • Recurrent disc herniations

  • Fused vertebrae

  • Painful pseudoarthrosis

  • Failure of other diagnostic tests