What is the anatomy of the disc of the spine (intervertebral disc)?
Picture of vertebral body, nerve, and disc
The disc is an important structure that rests between the bony building blocks of the spine (vertebrae). The disc in the spine is sometimes referred to as the intervertebral disc. Intervertebral discs help provide flexibility to our spine. They also lessen the effect of impact on our spine by cushioning the bony vertebrae. The disc is designed somewhat like a jelly donut. The disc has a stronger outer layer (the annulus) that is rather like a radial tire and an inner gel (the nucleus) that acts as a sort of shock absorber or cushion between the bones of the spine.
What happens to the disc with injury or age?
With injury or age, these discs can become damaged and the supporting ligaments surrounding them weaken. One of the reasons we lose height as we age is that the intervertebral discs lose their water content. This leads to shrinkage of the disc and, as a result, height diminishes.
What is a discogram used for?
An injured disc can be a source of pain. A discogram is an X-ray procedure used to determine if a particular disc is the source of pain. Discograms are provocative tests, meaning that they attempt to reproduce a pain rather than remove a pain. The reproduction of pain during a discogram can help the doctor determine if injury to a particular disc is the source of a person's pain.
How do health care professionals perform a discogram?
During a discogram, a needle is inserted into the disc and a contrast dye is injected. This extra fluid in the disc increases the pressure in the disc. Patients with an injured disc may then experience pain that can mimic the pain they have been experiencing. The intensity of the pain is recorded on a 0-10 scale.
How Painful Is a Discogram?
The needle insertions for IV and local anesthetic may cause a mild stinging pain from the pricking.
The discogram is designed to provoke existing pain to find out the source, so certain amount of pain is to be expected. If the disc is normal there will most likely be no pain, there might be a sense of pressure.
If the disc is abnormal, the discogram duplicates the patient’s original pain. The sedation helps reduce the patient’s pain and discomfort, and painkillers can be used to relieve the pain.
How do physicians interpret the results of a discogram?
Based upon the information provided by the discogram, the pain elicited can be correlated with the disc imaged in the test. Thus, the diagnosis of a particular disc injury can be made. The doctor can then determine what the optimal treatment options are for relief of the underlying pain.
Picture of discogram using fluoroscope
An actual discogram as visualized using an X-ray viewing instrument called a fluoroscope.
How long is the recovery time after a discogram?
Patients may be sore for several days after the procedure. Any discomfort can be treated with the local application of ice packs or with a cooling pad on and off for periods of 20 minutes.
What are potential side effects and complications of a discogram? Is pain associated with the procedure?
Because it is an invasive procedure, a discogram carries some risk of infection as a complication. This risk is exceptionally low as it is performed under sterile techniques. The discogram could also cause an injured disc to worsen and cause more symptoms.