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Discography is a diagnostic technique used to determine the cause of a patient's pain as related to spinal discs. The results are used to determine the best course of treatment, or for surgical guidance if the patient is a surgery candidate. The discography procedure will be able to tell the patient and their doctor which spinal disc, or discs, are causing the patient's pain. This diagnostic technique is typically used when the patient's pain is significant enough to possibly warrant the specific disc, or discs, being treated with target treatments, such as surgery to repair, remove, or replace the troublesome spinal discs.
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This procedure begins with the patient sometimes being administered a sedative to help them relax, but they cannot be put to sleep because they need to be able to communicate with their doctor about what they are feeling. Patients will also be given numbing medication that will be injected into the areas being injected with the dye. An x-ray contract dye, often combined with an antibiotic, is injected into the discs the patient is thought to be having pain from. Once all of the problematic spinal discs are injected, the patient will be asked to lie on their side or their back. As the discs are being injected with the dye, the patient will be asked if they feel pain, if the pain is their normal pain, or if the pain is worse.
Every patient will feel pressure during the injections, but they must tell their doctor if they are feeling actual pain and will have to describe the feeling and severity. How many discs are injected depends on the patient. Some patients will only need one disc injected while others will have two or more discs injected. The procedure will take approximately 30 to 45 minutes. The more spinal discs that are injected, the longer the procedure will take. A fluoroscope is used to guide the injection needles.
After this procedure, the patient will have CT scans done to examine the exact anatomy of the discs that were injected and to closely look at the bad area that could be causing the patient pain.
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What to Expect During Discography
There will be some discomfort involved as the needle is guided into the spinal disc, or discs, being injected. The skin and deeper tissues will be numb during this procedure and most patients receive some intravenous sedation. So, discomfort is involved, but is almost always tolerable.
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Risks and Recovery
Full recovery takes about two to three days. Patients typically experience soreness and increased pain in the areas they had injected. Patients will have to have someone drive them home and should not drive for at least 24 hours. Patients should limit activity for the day of the procedure and the following day. They should use ice for the day of the procedure and the day after to help ease pain and inflammation. They should apply the ice to the puncture sites for 20 to 30 minutes at a time with at least 30 minutes in between icing sessions. Patients should resume activities as they are tolerable. Most patients will take two to three days off from work following discography.
Pain is the most common risk of this procedure, but this is temporary and will subside to the patient's typical pain level after a few days. If a nerve root is brushed by the discogram needle, the nerve root can become irritated causing pain, which will almost always go away quickly. Other risks include bleeding, infection, and worsening of symptoms. Lower back spasms are common following discography, but will be temporary and the doctor will discuss ways to relieve these with the patient. Serious complications are rare.
Patients will be told what they can and cannot do following a discography. The patient's doctor will prescribe any necessary pain and/or muscle relaxing medications and will instruct them on how to take these.
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MetroHealth Medical Center. (2009). Discography. Retrieved on July 23, 2010 from MetroHealth Medical Center: http://www.metrohealth.org/body.cfm?id=2724&oTopID=2724
Deaconess Health System. (2010). Discography. Retrieved on July 23, 2010 from Deaconess Health System: http://www.deaconess.com/body.cfm?id=2614#7
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Hypodermic Syringe: iwanbeijes – sxc.hu