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Medical Article

Discogram,Discography and DIagnostic Procedure

Discogram is a radiological procedure used in the diagnosis of back-ache related to the inter vertebral disc.  Each inter vertebral disc  has a soft central part called nucleus pulpous and a surrounding fibrous ring called annulus fibroses Degeneration of the annulus  fibroses   can cause nucleus pulpous to protrude out ,resulting in bulged or herniated disc which can press the nerve causing pain

Diagnosis
Back pain is usually diagnosed by   X-RAY , MRI scan,  CT scan,  Discogram

Discogram
It is usually done for patients with back pain who do not respond to treatment by conservative methods  When test like  MRI scan   CT scan  fails to diagnose the affected disc

Who should not do discogram

Infection at the preoosed site of injection

Allergy to the dye- ominipaque is the dye used for the procedure Gadolinium may be used in those allergic to ominipaque

Bleeding problems may occur so ant platelet drugs and anticoagulants should be stopped before one week before the procedure

Pregnancy

How is Discogram Procedures Carried out

It is done under the guidance of fluoroscopy. Fluoroscopy is like a continues x ray which records moving objects.  A special needle is used for local anaesthesia and once the needle reaches the central part of the disc, the dye is injected.  The patient is ask to report if any pain is experienced and if the pain is similar to that the patient usually suffers from.  Injection of the dye in to the other disease to discs is carried out in the same procedure.  Injection into a normal adjacent disc is also carried out for comparison so that any bias due to the procedure can be ruled out.  Following the procedure the needle is withdrawn and local bandage is applied.  A CT Scan, x ray are also taken to study the dye in the disc.  The patient is monitored around two hours.

How is discogram interpreted ?

Pain : Where pain occurs when the disc is injected with the dye, the pain should be similar to the pain that usual y troubles the person.  At the same time pain should not be present from the adjacent normal disc. 

Amount of dye injected:  A degenerated disc usually takes up more dye as compared to a normal disc.

Structural changes of the disc :  Height of the disc is noted protrusion from the central part of the disc may indicate degenerative changes

Complications due to discogram

1.  Dicitis, which is inflammation of inter vertebral disc.

2.  Trauma,

3.  Damage to muscle of the back

4.  Damage to nerves

5.  Head ache.