Discography

Published by Bupa's Health Information Team, July 2011.

This factsheet is for people who are having discography, or who would like information about it.

Discography is a test that looks at the spine to locate specific areas that are causing pain.

You will meet the radiologist carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About discography

Discography uses a dye and X-rays to look at your spine and find any specific areas that are causing pain.

Your spine is made up of bones called vertebrae. They are separated by strong connectors called discs, which are made up of a type of connective tissue called cartilage. These discs act as shock absorbers and allow your spine to bend. Your spinal cord runs through the middle of each vertebra, carrying nerves from your brain to the rest of your body.

Your discs can become worn or they may split and slip in between your vertebrae. This condition is known as a herniated disc. Some herniated discs put pressure on your nerves and can cause pain or numbness in your legs.

A discography can find out which disc, if any, is causing your pain. It's usually only done if simple measures have failed to control your back pain and other tests such as an MRI scan haven't been able to identify the cause of your pain. Discography can help your doctor to plan surgery or other treatments.

Preparing for discography

Your doctor will explain how to prepare for your test.

You may be asked not to eat for a few hours before the discography. Follow the instructions given to you by your doctor.

Your doctor will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during discography

Discography is usually done in the X-ray or radiology department of a hospital. It takes between 30 and 45 minutes.

You will have a small plastic tube (cannula) placed into a vein, usually in the back of your hand. You may then be given a sedative medicine through the cannula, and other medicines if necessary. Sedatives relieve anxiety and help you to relax. You may also be given a dose of antibiotics to help prevent infection.

You will usually be asked to lie on your side or get into the prone position (lie face down) on the X-ray table. Your doctor may then give you an injection of local anaesthetic into the skin on your back to block pain from the area.

A special dye called contrast medium will be injected into the centre of each disc and X-rays will be taken. While this is being done, you will be asked to rate any pain or pressure you feel, usually on a scale of zero to 10. You will also be asked where the pain is and whether or not it is similar to your usual pain.

You may have a CT scan after your discography. A CT scan uses X-rays to make a three-dimensional image of your spine. A CT scan allows your doctor to see if there have been any changes in the size or shape of your discs.

What to expect afterwards

You will be able to go home when you feel ready. You will need to arrange for someone to drive you home.

Your doctor will review your test results and explain them to you at a follow-up appointment. Generally, if the X-rays show the dye has stayed in the centre of your disc, this means it is normal. However, if the dye has spread throughout your disc, or has leaked away, this means it may be damaged.

The test can help provide a better understanding of your back problem and your doctor will then be able to offer you suitable advice and treatment.

Recovering from discography

Sedation temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, please contact your motor insurer so that you're aware of their recommendations, and always follow your doctor's advice.

You may have some pain after the procedure. If you need pain relief you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Try to take it easy for the rest of the day. You must follow your doctor's advice about returning to work and getting back to your everyday activities.

What are the risks?

As with every procedure, there are some risks associated with discography. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your doctor to explain how these risks apply to you.

Discography involves having X-rays, which exposes you to radiation. The amount of radiation you have will depend on the number of X-rays you need and whether or not you have a CT scan after the discography. The benefits of you having this test should outweigh the risk related to the level of radiation you receive.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the test.

After the discography, you may have some pain or muscle spasms where you had the injection. Some people also have a headache or feel sick.

Complications

Complications are when problems occur during or after the test.

Complications of discography are rare. They include:

• infection in one of your discs
• damage to the nerves in your spine
• an increase in your back pain
• an allergic reaction to the contrast medium

If you're pregnant

Although the radiation dose used during a discography is generally thought to be safe for adults, it may harm an unborn baby. If you're pregnant, or think you could be, you must tell your doctor before your discography appointment.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.