Most men and women will experience lower back pain at least once in their lives, said symptom of which can be caused by a wide variety of illnesses and injuries. Doctors will then consider administering the diagnostic tool known as a lumbar discogram – or lumbar diskogram – to determine the exact cause of lower back pain, make a definitive diagnosis along with the results of other diagnostic exams (i.e., MRI and CT scan), and then implement the appropriate treatment plan.
What Is It?
A lumbar discogram is more about the physiology of the disk – read: determining if, indeed, the disk is the source of pain – and less about the anatomy of the disk. In many cases, even a disk that appears abnormal may not be the source of pain while a disk that appears relatively normal can cause severe pain. But a lumbar discogram is necessary, nonetheless, to diagnose a painful disc.
Yes, the MRI and CT scans are highly sensitive anatomic exams but these cannot be used to define actual pain generators. In contrast, a lumbar diskogram can induce pain in an identified sensitive disk and then the levels of pain experienced by the patient can be determined.
Doctors usually perform the procedure in preparation for lumbar fusion, which is a form of spine surgery wherein the motions of a painful vertebral segment are stopped. The surgery carries significant levels of risk and side effects, not to mention the lengthy recovery time, so the more information about the vertebrae, the better for risk management purposes. The information gathered from the lumbar discogram is used for this purpose.
Who Should Consider It?
The procedure is usually performed in patients with debilitating pain in their lower back, hips, groin or legs. But these patients must have suffered the pain despite comprehensive conservative treatment involving medications, physical therapy and home care, among other non-invasive methods. Patients must have also undergone several spinal diagnostic procedures, all to no avail because the primary pain generators have not been identified.
Your doctor will determine the necessity for a lumbar diskogram in your case. The decision will be made based on the availability of an experienced discographer and your physical condition, among other factors.
How Is It Done?
A lumbar discogram is an outpatient procedure involving little to no pain. Doctors and discographers usually follow these steps:
- Physical and medical exams are conducted to determine suitability for the procedure.
- Intravenous line is started in case medications may be necessary.
- Patient lies down a table where a fluoroscopic unit is positioned. Your back will be sterilized and the injection site marked.
- Local anesthesia is administered. A guide needle is directed toward the affected disc, which is then followed by a smaller disc needle.
- The discs are pressurized – small amounts of sterile liquid (i.e., contrast dye) are injected – to determine whether you feel nothing or you feel pressure or you feel pain (i.e., familiar and unfamiliar).
What Should Be Done After It?
You will be monitored for 30 to 60 minutes after the lumbar discogram. You may feel soreness and tenderness in the injection site but these are temporary. You are well advised to have someone drive the car for you because of the possible sedation involved.