Name of the Procedure:

Injection Procedure for Discography, Each Level; Lumbar
Common Name(s): Lumbar Discography, Discogram

Summary

Lumbar discography is a diagnostic procedure used to identify the exact source of lower back pain. During the procedure, a contrast dye is injected into the discs in the lumbar spine to make them visible on X-ray or CT scan.

Purpose

The procedure addresses chronic back pain that hasn't been diagnosed through other imaging tests. The goal is to identify damaged or degenerative discs causing pain, guiding further treatment such as surgery or other interventions.

Indications

• Persistent lower back pain unresponsive to conservative treatments (e.g., physical therapy, medication).
• Suspected discogenic pain.
• Pre-surgical planning for procedures such as spinal fusion.
• Clarification of MRI or CT scan findings.

Preparation

• Fasting for at least 6 hours before the procedure.
• Avoiding anti-inflammatory medications and blood thinners as instructed by the physician.
• Completing pre-procedural imaging tests, such as an MRI.
• Arranging for transportation home after the procedure, as driving is not advisable.

Procedure Description

1. The patient lies on their stomach on an X-ray table.
2. Local anesthesia is administered to numb the treatment area.
3. Using fluoroscopy (live X-ray), the doctor inserts a needle into the center of the lumbar disc.
4. Contrast dye is injected into the disc.
5. The patient is asked to report any pain caused by the injection.
6. Repeat the process for each lumbar disc level being tested.
7. After the injections, X-ray or CT images are taken for further evaluation.

Duration

Approximately 30 to 60 minutes.

Setting

The procedure is typically performed in a hospital's radiology department or an outpatient clinic equipped with fluoroscopy technology.

Personnel

• Radiologist or interventional pain specialist.
• Nurses or radiologic technologists.
• Anesthesiologist (if sedation is used).

Risks and Complications

• Infection at the injection site.
• Bleeding or hematoma.
• Nerve damage or irritation.
• Temporary increase in back pain.
• Allergic reaction to the contrast dye.

Benefits

• Accurate identification of painful discs.
• Helps in planning appropriate surgical or non-surgical interventions.
• Aids in determining the best course of treatment for chronic back pain.

Recovery

• Patients typically rest for a short period before going home.
• Mild soreness at the injection site for a few days.
• Restrictions on strenuous activity for 24 to 48 hours.
• Follow-up appointment to discuss results and treatment plans.

Alternatives

• MRI or CT scans without discography.
• Conservative treatments such as physiotherapy, medication, or spinal injections.
• Alternative diagnostic procedures like nerve block injections.

Patient Experience

• Temporary discomfort or pain when the dye is injected.
• Unpleasant but short-lived.
• Post-procedure pain relief measures such as over-the-counter pain medications.
• Cold packs to reduce soreness at the injection site.