Lumbar Discography / Intradiscal Injection

Target your low back pain with discography

Lumbar discography, or a discogram, is a diagnostic technique that uses x-ray beams to accurately place contrast dye on the inside of an intervertebral disc. Injecting dye in an abnormal disc may reproduce your low back pain, in which case this can be valuable information for your spine surgeon. This procedure also yields valuable information about disc shape, pressure level, and the presence of tears. In certain situations, a dilute mixture of local anesthetic and steroid is injected into the degenerated disc to bring lasting pain relief. This is called an intradiscal steroid injection, and may be performed if you have not had long-lasting relief with epidural steroid injections or lumbar transforaminal epidural steroid injections, and surgery is not recommended.

What are Intervertebral Discs?

Intervertebral discs are present throughout the spine in between the vertebral bones. Specifically, low back discs normally help cushion the spine from the weight of the upper body. Over time with wear and tear or after a trauma, these discs can degenerate, form tears in the outside fibrous ring (annulus fibrosus) or bulge out from their normal anatomical space. This disc bulge can put pressure on nerve roots and can cause inflammation and pain. If these discs continue to degenerate, it can require a discectomy and/or a lumbar fusion.

What to expect the day of your procedure

This procedure is performed in our in-office fluoroscopy suite using appropriate monitoring and conscious sedation, if desired. After check-in and meeting our OR staff, you will be brought to the procedure room and move to the prone position on the fluoroscopy table. One of our physicians will then numb your skin and subcutaneous tissues with a local anesthetic. Next, a small needle will be placed in the disc using x-ray guidance and contrast dye will be used. This dye will outline the disc shape and position. This process is repeated for each disc that is tested, typically 2-4 discs are examined in an appointment. After dye injection, a local anesthetic and steroid solution may be placed within the discs to help bring pain relief. The procedure typically takes about 15-30 minutes, with an additional 15-30 minutes to recover from anesthesia, if used. After your procedure, we will have you follow-up with our clinic or your surgeon to determine the next best step in your treatment plan. You may have some post-procedural soreness, but typically, ice, rest and small amounts of pain medicine like Tylenol are all that is needed to resolve this.

What should I tell my doctor before the procedure?

Please let our office know if you think you are pregnant, are on blood thinners, have any new or preexisting infections, have any major changes in your medical status, or if you have any specific concerns that you would like to address before the procedure.