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What is lumbar discography?
Lumbar discography is a test which helps determine whether the source of a patient’s low back pain is the lumbar discs. The discs are “shock absorbers” between the vertebrae of the spine. The procedure typically takes approximately 30 minutes.
How do I know whether I am a candidate for lumbar discography?
Lumbar discography is usually performed on patients in whom the cause of back pain is not explained by other imaging tests such as MRI or myelography. Lumbar discography may also be performed to evaluate other discs adjacent to a known abnormality in the lumbar spine. This helps the surgeon decide how extensive a procedure should be performed.
How is the lumbar discography procedure performed?
In this test, local anesthesia is administered and a small needle is introduced into the discs of the low back, using x-ray guidance. A small amount of x-ray dye is then injected directly into each disc and pictures are taken. As the x-ray dye is injected, the patient may or may not feel any pain. If the patient does feel some pain, the doctor doing the test will ask the patient to describe the nature of this pain. The doctor ordering the test will then use this information to determine the best treatment for the patient.
What happens the day of the procedure?
Lumbar discography is performed as an outpatient procedure. It is important you take any usual medications EXCEPT pain medications and aspirin, the morning of the procedure (pain medication may mask your pain response to the procedure, greatly decreasing the value of the test). If you are taking Plavix, you should discontinue this for 7 days prior to the procedure, with the approval of your doctor. If you are taking Coumadin, you should discontinue this for 3 days prior to the procedure, with the approval of your doctor. You will report to the hospital early in the morning, prior to the scheduled start of the procedure. You will be checked into the same day care ward, have an IV line placed, and be prepared for the procedure. After the procedure you will return to the same day care ward to be observed for about 2 hours. If the procedure results in any pain, this can be treated. Someone must accompany you to drive you home.
Most patients also have a CT scan to immediately follow the procedure and better image the discs.
Are there potential complications from lumbar discography?
Complications are rare and include infection, bleeding, or nerve “bruise”. You may have some back after the procedure which we can treat.
How will I know whether the procedure was successful?
The most important part of of the exam is whether or not you feel pain while the disc is injected with x-ray dye. There is no “right answer”. Both the presence of or absence of pain are important and useful responses.