What is a Discogram?
A discogram is an x-ray procedure to evaluate the intervertebral disc and to determine if your pain or other symptoms are specifically related to an abnormality of the disc. Disks are cushion-like pads made up of cartilage and a jelly-like substance. They act as shock absorbers between the bones in the spine. The intervertebral disc is a structure that is located between the spinal vertebrae. This procedure works by attempting to cause a pain similar to that you experience regularly. Each suspect disk is tested in turn. If the test duplicates your usual pain, the disk under examination is considered to be the source of the problem.
Franklin Moser, MD, Chief of Interventional Neuroradiology, heads our team of imaging physicians, nurses and technologists who specialize in these procedures.
How is a Discogram Performed?
A needle is placed into the nucleus pulposus of an intervertebral disc and a small amount of iodinated contrast is injected. The radiologist will localize the site for needle placement using fluoroscopic guidance. In addition to the pain control administered by an anesthesiologist, the radiologist will administer local anesthesia at the site of needle placement. Since the needle tip is in a location near the nerve roots, you may briefly experience symptoms such as pain or an electric shock sensation down your leg. A small amount of iodinated contrast agent is injected into the disc. At the time of the injection, you will be asked if the injection reproduces your pain or other symptoms. A series of radiographs are obtained after the injection to evaluate the condition of the disc. In most cases multiple disc levels are injected. Pain and discomfort at the time of the injection are common since one of the goals of this test is to determine if your symptoms are coming from irritation or compression of nerve roots by the disc. The pain may be as bad as the worst pain your back or spine trouble usually gives you. This pain generally subsides to your baseline level following the injection. You are conscious in light sleep during the procedure and can ask questions at any time. After the needle is removed, a CT scan is performed to provide further information. Occasionally, needle placement must be made from the midline with the needle crossing the sac that contains the nerve roots. In that instance, you may experience a headache after the procedure. If this approach is required, you will have to be observed in the hospital for several hours after the needle placement.
The S. Mark Taper Foundation Imaging Center provides a full range of advanced imaging, both radiology and cardiology, as well as interventional radiology and interventional tumor (oncology) treatments to the greater Los Angeles area, including Beverly Hills, Encino, Mid-Cities, Sherman Oaks, Silver Lake, Studio City, Toluca Lake, and West Hollywood.