Discogram

A discogram is an imaging test used to examine pain in your back. It helps determine if your pain is caused by an abnormality in your spinal disc. It can also be used before surgery to identify which discs need to be treated or removed.

Spinal discs are cushions that lay between your vertebrae to help absorb impact, provide spinal stability, and make it easier to move. When there is an issue with their alignment, positioning, or structural integrity, it can cause persistent pain that disrupts your quality of life.

Since a discogram is an invasive test that requires an injection of a contrast dye to guide imaging, your doctor may wait to perform it later in the diagnostic process after you’ve tried more conservative treatments like medication or physical therapy.

Penn Medicine offers one of the most sophisticated spine care programs in the country, providing treatment for every type of back and neck condition, including discogram imaging.  

Your doctor may recommend a discogram if they think your ongoing back pain is the result of a disc abnormality, and they haven’t been able to confirm it with an MRI or CT scan. You may also be a candidate if you’re preparing for a spinal fusion and your doctor wants to see the exact location of the discs that need treatment.

Your care team may wait four to six months to perform a discogram in order to give medication and physical therapy a chance to work. This will help them determine the likelihood of spinal disc injury and whether they should move forward with discography testing.

While a discogram involves an injection in the spine, it generally doesn’t cause serious pain or discomfort. You must be awake for the procedure so you can respond to your care team when they ask you about your pain level. Your doctor can answer any questions you may have so you are comfortable moving ahead with the procedure.

Discogram testing begins with your doctor numbing the spinal area they’ll be testing with a local anesthetic to ensure you don’t feel any serious pain or discomfort. Once the area is numb, they use x-ray imaging (also called fluoroscopy) to precisely guide the needle into the disc that needs to be examined. They’ll then inject a contrast dye into the disc to see if it spreads. If the dye spreads rather than staying in the center of the disc, it means the disc has sustained damage.

During the injection, your doctor will ask you to describe your level of pain. If your disc is causing your back pain, you’ll feel that pain intensify during the injection. If you don’t feel any pain, the disc is healthy. Before the test starts, you’ll be given an IV sedative to help you relax.

Your doctor will provide detailed instructions on how to prepare for your discography, including which medications to stop. A discogram is an outpatient test, and you’ll need someone to drive you home because of the sedative you’ll be given. The entire process, from prep to recovery, takes around three hours, but the actual test lasts around 30 minutes to an hour.

Your doctor will keep you for about an hour after the test for observation before you can go home. You’ll likely experience pain at the injection site for about a day after the test, but this can be relieved by applying an ice pack to the affected area. Contact your doctor right away if you develop a fever or back pain after two weeks. You can typically resume normal activities the day after your test.  

While discography is a safe procedure, there are certain risks involved with all invasive procedures. These are rare, but may include:  

• Infection
• Chronic back pain
• Headache or migraine
• Injury to nerves or blood vessels in and around the spine
• Allergic reaction to the dye 

While a discogram can help determine the cause of back pain, it’s rarely the primary means of diagnosis. In addition to discography, our specialists offer advanced imaging tests to determine the cause of your back pain, such as high-resolution MRI and CT scans and EOS imaging.

With specialists working together across multiple disciplines, including neurosurgery, orthopedics, pain medicine, and physical medicine and rehabilitation, we address the root causes of your back pain. This helps provide the most well-rounded care to increase your comfort, mobility, and quality of life and help you get back to living your life pain-free.