A lumbar discogram is a diagnostic procedure where contrast material is injected into one or more intervertebral discs. The special x-ray taken of the discs is called the discogram, which can show fissures, tears, and other disc damage. This test is useful for development of a treatment plan.
Why will the doctor order a lumbar discogram?
With age and/or injury, the wall of the disc can develop tears and cracks, which is often called degenerative disc disease. When the disc wall bulges and the inner gel-like material protrudes out, it can lead to a herniated disc. The lumbar discogram is used to determine if low back pain id caused by a damaged or degenerated disc, and to pinpoint the exact disc(s) causing the pain. This procedure is not a treatment, but rather, it is a useful diagnostic test.
What happens before the procedure?
At the medical facility, the procedure is explained to you and you are asked togive informed consent. An IV catheter is placed in your arm to administer precautionary antibiotics and a mild sedative. Driving after the procedure is not permitted for at least 24 hours.
How is the discogram performed?
The doctor will position you on your stomach, with pillows beneath the abdominal area. The skin along the low back is cleaned with an antiseptic, and anesthetized. You are also monitored with a blood pressure cuff, an oxygen device, and an EKG machine. Fluoroscopy is used to guide the needle which is inserted into the disc, and the contrast dye is injected in varying amounts. Questions may be asked regarding comfort and pain during this time, and x-rays are taken. When the procedure is over the needle(s) is/are removed and the site covered with a bandage.
How does the discogram feel?
The lumbar discogram involves numbing the skin, which feels like a mild burning. When the needle is placed into the disc, you may feel some pressure or mild pain. Also, when the contrast material is instilled into the disc, there may be some minor discomfort. You will only receive local anesthesia, but a mild sedative will make you more comfortable. Since the discogram is not a treatment procedure, it does not relieve the pain associated with the condition.
Are there any instructions to be followed after the procedure?
After the lumbar discogram, you must rest for 1-2 days. Ice is recommended to alleviate insertion site pain, which is applied for 15 minutes 3-5 times each day. After 1-2 days, it is alright to resume your routine but you should avoid showering, soaking in a tub, or swimmingfor a few days. You are advised to wait at least 2-3 days before returning to work.
What are the complications, risks, and side effects of the lumbar discogram?
The procedure is safe, but as with any minimally invasive test, there are some complications to consider. These risks include infection, worsening pain, nerve damage, blood vessel injury, and bleeding. Side effects include temporary pain at the injection site, allergic reaction to contrast dye or medications used, and slight weight gain.
Is the lumbar discogram an effective diagnostic test?
According to research, the discogram is 90% effective at showing which discs are damaged or degenerated. Because this test allows the doctor to view the outer aspect of the disc, it is easy to tell if or not there are disc-related problems.