09 Sep What is the purpose of a discogram?
Lumbar discogram procedures have been used for decades in the world of spine surgery and pain management. What exactly is the procedure and why is it used?
First and foremost, it needs to be understood right away that a discogram is not a therapeutic procedure. There is nothing achieved for pain relief at all during this procedure.
A discogram is a tool to confirm whether or not the patient’s back pain is coming from a particular disk space.
For instance, if an individual is experiencing low back pain with an MRI showing disc degeneration at L4-L5 disc space, the discogram can confirm whether or not that is where a person’s back pain is coming from. The spine surgeon will often order a discogram from a Seattle pain management physician to help make the preoperative decision of which level or levels to work on.
During a discogram, the patient is sedated and placed on an x-ray compatible table.
Using image guidance, the Seattle pain doctor will put a catheter into the patient’s disk space under review. In addition, the pain doctor will also place catheters in additional levels to make sure the pain is not being generating from them either.
The pain doctor will then slowly inject fluid to see if filling up the disc reproduces a patient’s typical pain in the low back. There are three possible outcomes with the discogram. One is that the person has the exact same pain experienced on a daily basis with injection of fluid into the disc. This is a positive result.
The second possible outcome is the individual actually does not experience the typical daily pain with fluid introduction, so this becomes a negative discogram.
A third possible outcome is that the injection only partially reproduces a persons back pain. This may mean that there are several levels at play with the pain.
It is important to note that pain management doctors in Seattle inject the levels above and below the level under evaluation to act as controls. There’s been debate for decades over the effectiveness of discogram for predicting the outcome with spine surgery.
There are plenty of studies which are in support of its ability to predict outcomes, while there are also plenty of others which show it is not so fabulous.
There are a few risks associated with the discogram. One is a risk of infection, bleeding. There’s also been concern over whether not performing a discogram increases the disc degeneration of that level. There is no definitive evidence either way on this yet.
To date, lumbar discogram procedures have been a very effective and helpful tool in the preoperative planning for spine surgeons. Call (855) WASH-PAIN for more information and scheduling with the top pain management Seattle trusts!