A lumbar discogram is an outpatient, invasive procedure used to evaluate the condition of the disks in the lumbar portion of the spine and determine if these disks are the cause of back pain. During a lumbar discogram, also known as a diskogram, contrast medium is injected into each lumbar spinal disk and then reviewed with an x-ray or computer tomography (CT) scan. The risks associated with a discogram include infection, nerve root damage, and spinal headaches.
The lumbar discogram is performed in a hospital room equipped with either an x-ray or a CT scan. Prior to the procedure, the patient is given an intravenous sedative and sometimes antibiotics. The patient is then positioned on his side to provide access to the back. After sterilizing the injection sites, contrast medium is injected into each lumbar disk. The patient will either feel no pain during this part of the procedure or will feel discomfort similar to the back pain that caused the need for the test.
After the contrast medium has been injected, the disks will be evaluated using either an x-ray or a CT scan to see whether the dye has moved within the lumbar disks. If the dye remains localized in the disk, the disk is healthy. Dye that has diffused from the injection site suggests that the disk has ruptured or torn. Following the review, the patient will be kept resting on the table to allow the sedative to wear off and to be sure the back pain does not intensify. The results of the dye injections and the pain or lack of pain associated with the injection are used to ascertain a diagnosis and determine the course of treatment.
There are a few possible complications associated with a lumbar discogram. The worst complication is discitis, an infection within the disk. This type of infection is difficult to treat, requiring strong antibiotics and mobilization of the back during recovery. Another complication is nerve root damage, which can result in pain or insensitivity in the lower back, bottom, or legs. A lumbar discogram can also produce a spinal headache or an extremely intense headache caused by the puncturing of the membrane surrounding the spinal cord.
This test is most often ordered to help determine the reason for a patient’s persistent back, hip, leg, or groin pain that has not been relieved by standard treatment. It may also be ordered when other diagnostic tools are unable to determine the cause of pain in these areas. A lumbar discogram may occasionally be ordered to evaluate the health of the spinal disks before a lumbar fusion surgery.
The use of the discogram to evaluate back pain is somewhat controversial. Some doctors believe that a discogram is a delicate, invasive surgery that does not always provide solid results and carries substantial risks. Other doctors feel that this procedure provides valuable information that cannot be gained through any other procedure.