• Diskography

    (Diskogram; Discography; Discogram)

    Definition

    Diskography is an imaging test. It involves injecting a contrast material into a disk in the spine and taking an x-ray . An x-ray is a test that uses radiation to take a picture of structures inside the body. The contrast material helps the disk appear more clearly on the x-ray.
    Herniated Lumbar Disk
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    Reasons for Test

    This test is used to detect if a herniated disk or otherwise abnormal disc is a source of pain. This occurs when a disk in the spine bulges from its proper place. Disks are small, circular cushions between the vertebrae (bones) in the spine. Herniated disks can press on the nerves and cause severe pain. In some cases, they can cause pain themselves, but often an abnormal disc is not painful.

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have diskography, your doctor will review a list of possible complications, which may include:
    • Disc degeneration
    • Infection
    • Nerve injury
    • Injection of dye into the wrong area
    • Bleeding
    • Allergic reaction to the contrast agent

    What to Expect

    Prior to Test

    Your doctor may do the following:
    • Physical exam and medical history
    • Pregnancy test—this test is not usually done on pregnant women
    • Determine if you have any allergies
    • Possibly prescribe a mild sedative to help you relax (In some cases, you may be sedated.)
    Your doctor may instruct you to:
      If prescribed a sedative:
      • Arrange to have someone drive you home from the care center. Also, arrange for someone to help you at home.
      • Take the sedative as directed by your doctor.
    • Before the test, remove any metal objects from your body (eg, jewelry, hearing aids, dentures).

    Description of the Test

    You will lie on your stomach or side on a table. A technician will help place you into position. You may be given antibiotics through an IV. You may receive an injection of local anesthetic into the skin on your back. This will be done to reduce pain from the needles.
    Your doctor will use an imaging test called fluoroscopy. It combines x-ray technology with a TV screen to help guide needles into the disks. A contrast dye will be injected into the center of each disk. If the disk is normal, the liquid will remain in the center of the disk. If it is abnormal, the x-ray will detect any leaks.
    During the exam, you will be asked to rate any pain that is associated with the injections. This can help your doctor find out if it is the abnormal disk that is causing pain. After this test, your doctor may do a CT scan to see the spread of the contrast dye.

    After Test

    The staff will observe you for 30 minutes or more.
    If you took a sedative, do not drive, operate machinery, or make important decisions until the sedative wears off.

    How Long Will It Take?

    About 30-60 minutes (an additional 30-60 minutes if a CT scan is also done)

    Will It Hurt?

    You may have pain from the contrast dye. Pain can last for several hours.

    Results

    The results will be given to your doctor. Your doctor will talk to you about the results and treatment options.

    Call Your Doctor

    After the test, call your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Severe pain
    • Numbness in your legs
    • Trouble urinating or moving your bowels
    • Symptoms of allergic reaction (eg, hives , itching, nausea, swollen or itchy eyes, tight throat, difficulty breathing)
    • Worsening of your symptoms
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/

    North American Spine Society http://www.spine.org/

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org/

    Canadian Orthopaedic Foundation http://www.canorth.org/

    References

    Carragee EJ, Don AS, Hurwitz EL, Cuellar JM, Carrino JA, Herzog R. Does discography cause accelerated progression of degeneration changes in the lumbar disc: a ten-year matched cohort study. Spine. 2009;34(21):2338-2345.

    Diskography. North American Spine Society website. Available at: http://www.spine.org/fsp/troubleshooting-diskography.cfm . Accessed May 30, 2007.

    Diskography: science and the ad hoc hypothesis. American Journal of Neuroradiology website. Available at: http://www.ajnr.org/cgi/content/full/21/2/241 . Accessed June 6, 2007.

    Stout A. Discography. Phys Med Rehabil Clin N Am. 2010;21(4):859-867.

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