A discogram (also referred to as disc stimulation testing or provocative discography) is a diagnostic procedure used to precisely diagnose if the spinal discs are injured and the source of a patient’s back pain. This procedure also helps the physician view and asses the internal structure of the disk. The discs in your spine are a soft cushion that sits between each vertebra, the bones that make up the spinal column. As people age, the spinal discs dry out and become less flexible and are more susceptible to tear or rupture. An injury to the disc can be a major source of pain. A discogram may help your doctor determine whether the disc (and which disk in particular) is the source of the pain.
Discograms are typically used to identify the source of a patient’s pain, typically back pain referred to as discogenic pain. Discograms are used to determine whether the disc in question is the cause of a patient’s pain versus other common causes of back pain such as facet syndrome and sacroiliac joint pain. Discorgrams are also commonly used to guide surgery regarding which particular disc is damaged and causing a patient’s pain.
Discograms are performed as an outpatient procedure in the procedure suite under sterile conditions. The patient is typically given an intravenous sedative to help with relaxation during the procedure, along with antibiotics. The patient is positioned on the table on their stomach lying face down. Then the skin is cleaned, and a local anesthetic is injected to numb the area. The physician will pass a needle through the skin and tissues and into the center of the disc to be examined under X-ray guidance. Once the needle is inside the disc, a contrast dye is injected, and an X-ray is taken to visualize the spread of the contrast dye. If the disc is normal, the dye will remain in the center. If the dye spreads outside the disc it may indicate tears in the outer ring of the disc. During the procedure, when an abnormal disc is injected, the patient may feel pain like their typical back pain.