Discography is a procedure designed to test the disc itself for pain generation. It is done by placing a needle inside the disc and then pressurizing the needle. That simulates standing up or loading the disc.
In the diagram to the right (IMAGE 1), three discs are noted. The top two are normal and the bottom one is abnormal. You can see the dye is spread backwards, next to the nerve roots. Many of those patients will get either isolated back pain when they flex forward or they may also get leg pain where the disc contents come out into the neural foramen (or the place where the nerve comes out).
This technique records X-ray information, the patients response to pressure and PSI measurement at the same time (IMAGE 2).
Discography is a high level diagnostic procedure where a needle is placed into the disc and three separate video recordings are performed at the same time. The X-ray is being recorded where the dye is flowing, as the dye is being injected. Pressure inside the disc is being recorded and the patients face and verbal responses are being recorded. The advantage of this is to make this a permanent copy of the patients record. If there is ever a question as to what exactly was said, this is recorded also. The pressure inside the disc is being recorded which gives further information to quantify the pain, as well as recording the output of where the dye is actually flowing.
Post Discogram Complications
Discography is done as a pre-surgical technique. Possible complications include:
Possible nerve trauma since the disc and nerve root are in close
proximity. Possible
postdural puncture headache, since the dura occasionally needs to be punctured.
Possible
discitis or disc infection which is very rare, however, if it occurs the
treatment is usually removal of the infected disc.
Possible
spinal cord trauma during thoracic or cervical discograms. This is even
more rare than discitis. This is not a risk in the lumbar discograms below
L-2.IMAGE
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IMAGE 2
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