Discogram Procedure: What to Expect From Diagnostic Discography

Your MRI shows several worn discs, but which one is actually causing the pain? Imaging can’t always answer that, because discs that look damaged don’t always hurt. A discogram procedure helps close that gap by testing individual discs to see which one reproduces your usual pain.

What Is a Discogram?

A discogram is a diagnostic test that helps show whether a specific spinal disc is the source of your back pain. It does not treat pain. Instead, it gives your physician information to plan treatment when other tests haven’t pointed to a clear answer.

During the test, a small amount of contrast dye is injected into the center of one or more discs to slightly increase the pressure inside them. If the injection reproduces the pain you normally feel, that disc is more likely to be involved. The dye also shows up on X-ray, revealing tears or other changes in the disc wall.

According to a StatPearls review from the National Library of Medicine, discography is typically considered for low back pain lasting 3 months or more despite conservative care, when imaging is unclear, and the results are expected to change the treatment plan.

What Happens During a Discography Procedure?

A discography procedure is an outpatient visit performed under live X-ray (fluoroscopy) guidance. You lie face down, and the skin is cleaned and numbed. Light sedation may be used to help you relax, but you stay awake enough to describe what you feel, since your feedback is key to the test.

Your physician guides a thin needle into the center of each disc being tested, then slowly injects contrast dye. As each disc is pressurized, you’ll be asked whether you feel pain, where it is and whether it matches your usual pain. A CT scan is sometimes done afterward for a more detailed picture.

A lumbar discogram procedure tests discs in the lower back. Doctors can also test discs in the neck when cervical disc pain is suspected.

You’ll rest briefly afterward, and you should plan to have someone drive you home.

How Are Discogram Results Used?

Discogram results help your physician decide where to focus treatment. If a disc clearly reproduces your pain, treatment may center on that disc, which is common with degenerative disc disease or a herniated disc. Options may include an epidural steroid injection or, in some cases, a surgical referral.

If no disc reproduces your pain, the source may lie elsewhere, such as the facet joints. In that case, your physician may recommend facet joint injections or a medial branch block, which can lead to a rhizotomy if facet pain is confirmed.

Risks of a Discogram

Complications are uncommon, but like any procedure that enters the spine, a discogram carries risks. StatPearls reports overall complication rates ranging from 0% to 2.7%, with many studies below 1%. The most serious risk is infection of the disc (discitis). Others include bleeding, headache, nerve irritation and a reaction to the contrast dye. Questions about possible long-term effects on punctured discs are one reason the test is reserved for cases where results will change the plan.