What is a Discogram?
Discogram explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Discogram, also known as a discography, is a procedure designed to diagnose neck and lower back pain. Discogram was developed by physicians in the 1940s to locate painful defects in intervertebral discs. Doctors in the U.S. refined the procedure in the early 1960s and developed clinical standards. By this time, the accuracy of Discogram in detecting conditions such as disc degeneration was superior to other similar techniques available at the time.
Modern Discogram is mostly applied in cases of local neck and back pain that may or may not spread beyond these areas. Discogram may be required when other conditions that cause pain, such as facet joint damage and muscle strain, have been eliminated as possibilities. Discogram is associated with accurate identification of weaknesses or degeneration in the intervertebral discs. It can contribute to appropriate recommendations of surgery or other procedures to treat disc disorders if diagnosed.
How is Discogram Performed?
The physician or pain specialist performing Discogram may first administer sedatives to the patient if necessary. The patient is positioned on an X-ray table and the skin above the area affected by pain is sterilized. Local anesthetics are administered to this region. The disc(s) suspected of causing pain will be located carefully, using imaging techniques such as fluoroscopy. A contrast dye is then injected into them. This dye will dissolve away after the procedure. The dye may highlight defects or weaknesses in the discs. In addition, the injection of the dye may cause the chronic pain reported by the patient, indicating that it is indeed disc-related. If there is no pain in the course of the procedure, then it is not likely to be associated with disc disease.
The average Discogram takes from thirty minutes to an hour in total. Research associations in the areas of spinal pain and treatments such as the International Spine Intervention Society (ISIS) officially recognize Discogram as a safe and effective method to diagnose sources of neck and back pain. ISIS recommendations and benchmarks for cervical and lumbar pain detection are all met by Discogram.
Discogram has been shown to be more accurate in detecting disc problems than other techniques such as MRI. Research indicates that MRI is effective in identifying general signs of disc disorder, but that Discogram is superior in pinpointing the exact type of disorder. Discogram is particularly associated with avoiding unnecessary back surgeries. Some surgeons have observed that Discogram results have prevented invasive procedures that would have been ineffective and potentially risky. Locating the disc that is the specific source of chronic pain is the best way of treating it.
Discogram is a procedure with limited surgical invasion and tissue damage. However, there are some risks. These complications are relatively rare though. A headache that often results from interventions performed in the spine is an example of an adverse event associated with Discogram. Others include bleeding and infection. If a needle is inserted at the wrong point in the spine, numbness or paralysis could result from this. Hoarseness of the voice is another complication that can result from a Discogram procedure. There may also be some pain lasting for about seven days as part of recovery from a discogram. This can be treated by the application of ice to the affected area and by mild painkillers.
Conditions Related to Discogram
Back pain is a common complaint. It is estimated that 80% of people in the U.S. will suffer from this at some point in their lives. It is a considerable source of economic and healthcare burden. The exact condition responsible for each case can be difficult to diagnose. It is reported that 90% of cases do not have a specific diagnosis. This may be due to the fact that many conditions can cause neck or back pain of a similar intensity and nature. These can include vertebral fractures, disc herniation, osteoarthritis, arthritis, spondylolisthesis, spinal stenosis, and other conditions such as infections.
Other techniques to diagnose back pain include MRI, patient assessments, and lumbar puncture. If these fail to accurately diagnose the cause of back problems, or if a physician has reason to think disc problems are involved in a case of chronic pain, Discogram is often employed to eliminate this possibility. Disc pain originates from herniation or from degeneration of the tissues that make up a disc. These conditions are associated with either trauma through an accident or injury, or with advanced age.
Discogram is associated with accurate diagnosis of conditions affecting the intervertebral discs of the spine. This often leads to the most appropriate and effective options of treatment. Discogram involves the injection of contrast dye into the disc(s), which reveals the type and extent of the disorder present.
This procedure may be a viable option in a case of pain that has not responded to other treatment methods.
- Borthakur A, Maurer P, Fenty M, et al. Magnetic resonance imaging and Discogram pressure as novel biomarkers for disc degeneration and low back pain. Spine Diagnostics. 2011;36(25):2190-2196.
- Chen JY, Ding Y, Lv RY, et al. Coorelation between MR imaging and Discogram with provacitive concordant pain in patients with low back pain. Clin J Pain. 2011;27(2):125-130.
- Manchikanti L, Boswell MV, Singh V, et al. Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2009;12:699-802.
- Provenzano D. Diagnostic Discogram. What is the Clinical Utility? Curr Pain Headache Rep. 2012;16:26-32.
- Reeves R, Furman M. Discogram’s role in low back pain. Pain Manage. 2012;2(2):151-157.
- Medscape Reference: Discogram – Retrieved Nov. 2013 from http://emedicine.medscape.com/article/1145703-overview