FAQ’s on Lumbar Discogram
For patients with persistent low back pain, a diagnostic test may be recommended to evaluate intervertebral disc pathology. In studies, lumbar discograms can be effective in diagnosing patients in 46% of cases of symptomatic vs. asymptomatic disc degeneration ( Provocative lumbar discography versus functional anesthetic discography: a comparison of the results of two different diagnostic techniques in 52 patients with chronic low back pain 2011).
What is a Lumbar discogram?
A lumbar discogram, Lumbar Discography, or Lumbar provocative discographyis a
mildly invasive diagnostic procedure used to evaluate the intervertebral disc in persons suffering from chronic lumbar back pain that have shown negative or unsatisfactory response to all non-surgical forms of conservative treatment and are being evaluated for surgical intervention (‘Progressive-onset’ versus injury-associated discogenic low back pain: features of disc internal derangement in patients studied with provocation lumbar discography 2013).
What are expectations when a patient receives a lumbar discogram?
When the lumbar discogram procedure is administered, the patient can expect certain low levels of discomfort and pain. The procedure will usually cause the patient to feel the amount of pain they normally experience in the suspect disc area. Part of the procedure is to determine pain levels and to determine the patient’s expectations of benefit from surgical procedure. Because of this, the lumbar discogram procedure may also be used to detect patients who exaggerate their condition. The procedure is performed and will have very specific results which cannot be emulated or manipulated (Operative and Nonoperative Treatment Approaches for Lumbar Degenerative Disc Disease Have Similar Long-Term Clinical Outcomes Among Patients with Positive Discography 2013).
How is the lumbar discogram procedure performed?
There may be slight variations in the procedure, but the procedure is typically performed under local anesthesia which numbs the skin and soft tissue in the area of the disc (s) to be examined. Up to four discs at a time may be examined. Once the area has been numbed the physician then uses fluoroscope imaging to guide a thin needle to correct placement in the disc.
A radio-opaque dye is then injected into the disc in question and then an x-ray is performed to see if any dye leaks out. If dye leaks out this would be indicative of a tear or similar type of damage in the outer layer (annulus fibrosis) of the disc being examined. Often a CT scan will be performed after the injections for a better view of the dye distribution throughout the affected disc (Comparison of four different analgesic discogram protocols comparing the incidence of reported pain relief following local anesthetic injection into concordantly painful lumbar intervertebral discs 2012).
The lumbar discogram procedure typically takes thirty to forty five minutes to perform and is an outpatient procedure. You should not eat or drink for at least eight hours prior to the procedure. If you take regular prescription medications, take them as prescribed, however if you take blood thinners you should consult with your physician as they may ask you to not take them the day of the procedure.
What risk or side effects are there for patients undergoing the lumbar discogram procedure?
The lumbar discogram is a low risk procedure, but there may be minimal risks involved. These include initial pain, slight swelling, and discoloration or light bruising at the site of the injection(s), Discitis (inflammation of the disc), infection at the injection site, or infection of the disc. However the physician will often prescribe powerful antibiotics as a preventive recourse to prevent infection due to the sensitive location of the procedure (Peripheral disc margin shape and internal disc derangement: imaging correlation in significantly painful discs identified at provocation lumbar discography 2012).