Diskography

(Diskogram; Discography; Discogram)

Definition

Diskography (or discography) is an imaging test used to detect a herniated disk . It involves injecting dye into a disc in the spine and taking an x-ray to determine if there are any leaks.

Herniated Lumbar Disc

Parts of the Body Involved

Spine
Vertebral disk(s)

Reasons for Procedure

Diskography is used to detect a herniated disc. A herniated disc occurs when discs in the spine bulges from its proper place. Discs are small circular cushions between the vertebrae (bones) in the spine. Herniated discs press on the nerves and can cause severe pain.

Risk Factors for Complications During the Procedure

Allergies, especially to x-ray dye or xylocaine
History of seizures or epilepsy
Diabetes
Pregnancy

What to Expect

Prior to Procedure

Your doctor will likely do the following:

Physical exam and medical history
Pregnancy test
Determine if you have any allergies
Possibly prescribe a mild sedative to help you relax

Also keep in mind the following:

Do not eat solid foods after midnight the night before your exam.
Wear comfortable clothing.

Anesthesia

You may receive a mild sedative to help you relax or an anesthetic to reduce the pain of the needles.

Description of the Procedure

You will lie on one side of a table. A technician will help place you into position. You may be given antibiotics through an intravenous line. You may receive an injection of local anesthetic into your skin to reduce the pain of the needles.

Your doctor will use an imaging procedure called fluoroscopy, which combines x-ray technology with a television screen, to help guide a series of needles into one or more of your vertebral disks. A contrast liquid 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 determine if it is the abnormal disk that is causing your pain.

Oftentimes, your doctor will perform a CT scan after diskography to visualize the spread of the contrast liquid.

After Procedure

You will likely be kept for observation for 30 minutes or more.

How Long Will It Take?

The procedure a takes about 30-45 minutes. A CT scan will add an additional 30-60 minutes.

Will It Hurt?

Depending on your condition, you may feel pain as the contrast liquid passes through your disk. This pain can persist for several hours and may be associated with some residual muscle pain.

Possible Complications

Infection of the disk space
Nerve root injury
Urticaria (hives)
Injection of dye into the dural sac
Bleeding
Pulmonary embolism
Nausea
Headache
Increased pain
Allergic reaction to the contrast agent
Risks of radiation to your fetus if you are pregnant

Average Hospital Stay

You will be able to go home after your exam.

Postoperative Care

If you took a sedative, do not drive, operate machinery, or make important decisions until the sedative wears off completely.
If breastfeeding, your doctor may advise you to wait at least 24 hours after the exam before breastfeeding again, due to the contrast agent.

Outcome

The results of your diskography will be given to you and/or your primary physician. Your doctors can use the results of your diskography to determine if surgery may be beneficial in reducing your pain.

Call Your Doctor If Any of the Following Occurs

Intense pain
Symptoms of allergic reaction (eg, hives, itching, nausea, swollen or itchy eyes, tight throat, difficulty breathing)
Worsening of your symptoms

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:

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.

Last reviewed April 2008 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.