Discography is the injection of local anesthetic and dye injected into a disc in the back. Discography is used to determine which disc area is painful and usually serves as a diagnostic tool for your surgeon. A minimum of two discs will be injected. If you have x-ray findings of disc problems at many levels, you may need more discs injected.
What are the risks of the procedure?
The main risk of the procedure, though it happens less than 1 percent of the time, is discitis. Discitis is an infection in the disc that can lead to an infection in the spine. Every effort is made to prevent this from happening, including giving antibiotics before the procedure and using sterile techniques.
There is also a chance of what is called a paresthesia, a shooting "electric-shock" type of pain. This generally occurs when the medicine is injected into the disc and more pressure is put on the nerve. This usually passes quickly, but on rare occasion it continues. As with most procedures, there is a remote risk of bleeding, infection, nerve injury or allergic reaction to the medications used.
Some short-term side effects may occur. If local anesthetic spreads to nearby nerves, you may have weakness or numbness that can last for several hours. If this happens, you may have to stay in the Pain Management Center until this resolves. You may have increased pain for a few days after the injection, including localized pain at the injection site.
The procedure cannot be performed if you have an active infection, flu, cold, fever, very high blood pressure or if you are on blood thinners. For your safety, please make your doctor aware of any of these conditions.
Will the injection hurt?
Your skin will be numbed with a local anesthetic. This is usually felt as a stinging/burning sensation. Once the needle is in the disc, however, it may be painful as the medicine is injected, since the goal of the procedure is to try to reproduce your usual pain.
What happens during the actual procedure?
You will need to arrive one hour before your actual injection time so that an intravenous can be started and an antibiotic given. Let the doctor know if you have any allergies to antibiotics and/or dyes.
It takes roughly 45 minutes for the antibiotic to get to the disc. You will wait in the recovery area during this time. You may want to have your ride keep you company or bring something you enjoy doing, such as reading or knitting.
After you sign a consent form and your blood pressure is checked, the intravenous will be started and the antibiotic given. About 45 minutes to 1 hour later, you will be escorted into the fluoroscopy (x-ray) room. You will be asked to lie on the table on your stomach.
Your back is cleansed with an antiseptic soap. Sterile drapes are placed. The skin is then anesthetized (numbed) with a local anesthetic. This is felt as a stinging/burning sensation.
Using x-ray guidance, the needle is advanced to the appropriate position (into the disc), and local anesthetic and dye are injected. You will be asked to let the doctor know whether or not this causes your usual pain. The needle will then be removed.
This process will be repeated at as many levels as needed. Your skin will be cleansed and bandages will be applied. The bandages can be removed the next morning. Your blood pressure will be checked, and you will be discharged to leave with your ride after the doctor authorizes your discharge.
How will I feel after the injection?
It is not unusual to feel sore after the injection. Your usual pain may be somewhat increased after discography. You may experience muscle soreness in your back from the needle placement. This can be helped by using ice packs three or four times a day. You may take your usual pain medications after the injection as well.
Will I have any restrictions on the day of the procedure?
Do not eat or drink anything for six hours prior to the procedure, except for sips of water to take your usual medications. Please follow this instruction unless told differently by your doctor.
You may not drive for the remainder of the day after your procedure. An adult must be present to drive you home or to go with you in a taxi or on public transportation. For your safety, the procedure will be cancelled of you do not have a responsible adult with you.
No heat is to be used in the injected areas for the remainder of the day. You should not take a tub bath or soak in water (such as a pool or hot tub) for the remainder of the day.
For what reasons should I call the Center for Pain Medicine?
If you experience severe back pain, new numbness or weakness of your legs, or signs of infection in the area of the injection, you should call the Center for Pain Medicine at 617-732-9060.