What is a discogram? A discogram or discography is an invasive imaging method of the intervertebral discs of the spine, which is performed with the aim of evaluating the source of chronic back or neck pain. Unlike MRI, which only shows the structure of the disc, a discogram provides detailed information about the function and reaction of the disc to pressure by injecting contrast material into the disc. During the injection, if the patient's pain is reproduced, it indicates that the disc is the main cause of the pain. This method is usually prescribed for patients who are candidates for surgery or who are suspected of **degenerative disc disease** and the doctor needs to accurately determine the affected area in order to carry out a more targeted treatment. Application of lumbar discography
Lumbar discography is one of the accurate and practical methods for diagnosing intervertebral disc problems. This method is used when chronic back pain cannot be diagnosed well with other methods such as MRI or CT scan. In fact, a discogram can pinpoint exactly which disc is the source of the pain; In the following, we mention the most important applications of this method. 1. Diagnosing the disc causing the pain: The most important application of discography is to accurately determine the disc that is the main source of the patient's back pain, especially in cases where other images are not sufficient. 2. Evaluation before spine surgery: Doctors use a discogram to determine which disc needs surgery. This information is critical for accurate surgical planning. 3. Determining the most appropriate level for fusion (vertebral fusion surgery): In patients undergoing spinal fusion, the discogram determines which level requires stabilization. 4. Differentiate between a damaged disc and a painless disc: In some cases, a disc may appear damaged on MRI but not cause pain; The discogram defines this difference. 5. Investigating the amount of damage to the intervertebral disc: the injection of contrast material in the discogram shows the condition of the internal structure of the disc and determines the degree of its rupture or destruction. 6. Avoiding unnecessary surgeries: By accurately identifying the source of pain, surgery on discs that are not responsible for pain can be avoided, which reduces both costs and complications. By providing functional and structural information about the discs, this method helps doctors make better clinical decisions about the treatment and **prevention of lumbar disc disease**. The process of lumbar discography
Lumbar discography process is performed on an outpatient basis in a sterile environment. First, the skin of the lower back is cleaned with disinfectants and local anesthesia is injected. Then, guided by fluoroscopy (live X-ray) images, the doctor inserts a thin needle into the suspected disc and injects a small amount of contrast material. At the same time, the doctor asks the patient if he experiences pain similar to his usual pain or not. This answer is very important for diagnosing painful discs; After the injection, a CT scan is usually taken of the disc to examine the internal structures more closely. Preparing for a lumbar discogram
Before performing a discogram, the patient must follow the medical instructions exactly. Usually, he should fast a few hours before and stop taking blood thinners (such as warfarin or aspirin) with the doctor's advice. Patients should inform the history of sensitivity to contrast agents or drugs. On the day of the test, it is better to come with a companion, because after the injection, a temporary feeling of weakness or pain may occur in the lower back. Wearing comfortable clothes and refraining from driving after performing a discogram is also recommended; The doctor will explain all the safety points before starting the procedure. Is discogram dangerous? Although discography or discogram is a relatively safe and very accurate method to diagnose the cause of back pain, like any invasive method, it can be associated with possible complications and risks; In the following, we will examine the most important possible complications of this method. - Temporary pain after injection: some patients may experience pain in the lower back for a few days after injecting the contrast agent in the disc. - Disc infection: In rare cases, the entry of microbes into the disc can cause an infection that requires antibiotic treatment or even hospitalization. - Damage to the intervertebral disc: In case of incorrect injection or excessive pressure, there is a possibility of mechanical damage to the disc. - Allergic reaction to the contrast material: In sensitive people, the body may show an allergic reaction to the contrast material, which can usually be controlled with medication. Headache or nausea after the test: In rare cases, some patients experience transient headache or nausea after the discogram. - Bleeding or bruising at the injection site: As with any other injection, there is a possibility of minor bleeding or bruising at the injection site. By observing health principles, choosing an experienced doctor and performing tests before injection, the probability of these risks is very low. However, being aware of them will help you make a more informed decision. What is the recovery time after a discogram? Recovery after a discogram is usually quick, and most patients can return to their daily activities within one to two days. However, some people may experience pain or discomfort at the injection site for a few days after the test, which can be controlled with simple pain relievers. In case of abnormal symptoms such as fever, severe pain or discharge from the injection site, the doctor should be informed immediately. Usually, the doctor recommends that you have a relative rest and avoid heavy activity for a day after the discography. Does discography cause back pain? Lumbar discography is usually performed under local anesthesia, but the patient may experience pressure or pain similar to their chronic pain when the contrast material is injected into the disc. In fact, reproducing this pain is important to the doctor because it helps identify the disc responsible for the pain. Some patients only experience mild discomfort, while others may experience more severe pain that is temporary. After a discogram, mild pain in the lower back may remain for a few days, which can usually be controlled with simple pain relievers and is nothing to worry about. Difference between discogram and MRI
The following table provides a comprehensive comparison between the two imaging methods, discogram and MRI. These two methods are used with different purposes in diagnosing spinal disc problems, and each has its own advantages, limitations, and applications. By reviewing this table, one can gain a more accurate understanding of the key differences between these two methods in terms of how they are performed, the type of information obtained, how invasive they are, and their role in the diagnosis process. Investigating the cause of back pain with back discography
Lumbar discography is an advanced and accurate tool to identify the true origin of chronic low back pain, especially when other methods such as MRI have not been able to accurately diagnose. By injecting contrast material into the disc and reproducing the pain, this method shows the doctor which disc is the real cause of the patient's pain. According to Dr. Mahmoud Yazdan Panahi, using a discogram before surgery can prevent many unnecessary interventions and make the treatment path more targeted; For this reason, discography is particularly important as a supplement to spinal surgery decisions.
