Spinal Discography

Spinal discography or discogram is a test used for the diagnosis of pain related to spinal disc diseases. It is very useful when a patient has many problems with his or her spinal discs, and the doctor is not sure where the pain is coming from.

The test is simple and safe. It is done under x-ray guidance with sedation. Tiny spinal needles are inserted into the spinal discs while the patients are sedated. These discs include normal ones and pathological ones based on MRI or CT images. The patients are woken up from the sedation while the needles are well positioned. A dye (contrast) is injected into each disc and the patient is asked if the contrast provokes his or her typical pain. A normal disc usually does not produce pain whereas a pathological one typically reproduces the pain. At the same time, the flow of dye in the disc is visualized under X-ray to determine if the patients have disc tears or disruptions. The details of disc problems are determined with a CT scan that follows the test.

With discogram test, an experienced physician can distinguish between the pathological ones and the healthy ones and determine whether or not the pain generators are related to spinal disc diseases. As with any other medical test, the discogram test has false positive and false negative results. One should never rely on one test result to make decisions. To make a sound clinical judgment, a good doctor always knows how to collect and analyze a patient's history, physical exams, and test results together with knowledge, skill, experience, and confidence.