What is discography?
Discography is the injection of local anesthetic and dye injected into the disk. Discography is used to determine which disk level(s) is painful, and is usually used as a diagnostic tool for your surgeon. A minimum of two disks will be injected. If you have x-ray findings of disk problems at many levels you may need more disks injected.
Note: The procedure can not be performed if you have an active infection, flu, cold, fever, very high blood pressure, or if you are on blood thinners. Please make Dr. Dominguez aware of any of these conditions. This is for your safety!
What are the risks of the procedure?
The main risk of the procedure, though it happens less than 1% of the time, is diskitis. Diskitis is an infection in the disk that can lead to an infection in the spine. Every effort is made to prevent this from happening – antibiotics before the procedure, sterile technique, etc.
There is also a chance of what is called a paresthesia – a shooting, “electric-shock” type pain. This generally occurs when the medicine is injected into the disk and more pressure is put on the nerve. This usually passes quickly but on rare occasion it continues. As with most procedures there is a remote risk of bleeding, infection, nerve injury, or allergic reaction to the medications used.
Some short-term side effects may occur. If local anesthetic spreads to nearby nerves you may have weakness or numbness that can last for several hours. If this happens you may have to stay in the surgery center until this resolves. You may have increased pain for a few days after the injection, including localized pain at the injection site.
Will the injection hurt a lot?
Your skin will be numbed with a local anesthetic. This is usually felt as a stinging/burning sensation. Once the needle is in the disk, however, it may be painful as the medicine is injected as the goal of the procedure is to try to reproduce your usual pain.
What happens during the actual procedure?
You will need to arrive 1 hour before your actual injection time so that an intravenous can be started and an antibiotic given by the Anesthesiologist. (Let the doctor know if you have any allergies to antibiotics and/or dyes). It takes about 45 minutes for the antibiotic to get to the disk – you will wait in the recovery area during this time (you may want to have your ride keep you company or bring something you enjoy doing – reading, crocheting, etc).
After signing a consent form and checking your blood pressure by the nurse, the intravenous will be started and the antibiotic given. You will be asked to lay on the table on your stomach. The back is cleansed with an antiseptic soap. Sterile drapes are placed. The skin is then anesthetized (numbed) with a local anesthetic. This is felt as a stinging/burning sensation. Using x-ray guidance the needle is advanced to the appropriate position (into the disk) and local anesthetic and dye are injected. You will be asked to let the doctor know whether or not this causes your usual pain. The needle will then be removed. This process will be repeated at as many levels as needed. Your skin will be cleansed and bandages will be applied. (The bandages can be removed on the next morning). Your blood pressure will be checked and you will be discharged to leave with your ride after Dr. Dominguez authorizes your discharge.
How will I feel after the injection?
It is not unusual to feel sore after the injection. Your usual pain may be somewhat increased after the discography is done. You may experience muscle soreness in your back from the needle placement. This is helped by using ice packs three or four times a day. You may take your usual pain medications after the injection as well.
Will I have any restrictions on the day of the procedure?
Do not eat or drink anything for six (6) hours prior to the procedure except for sips of water to take your usual medications. Please follow this instruction unless told differently by Dr. Dominguez.
You may not drive for the remainder of the day after your procedure. An adult must be present to drive you home or to go with you in a taxi or on public transportation. The procedure will be canceled if you don’t have a responsible adult with you!! This is for your safety.
No heat is to be used in the injected areas for the remainder of the day.
No tub bath or soaking in water (i.e. pool, jacuzzi, etc.) for the remainder of the day.
For what reasons should I call American Pain Institute after the injection?
If you experience severe back pain, new numbness or weakness of your legs, or signs of infection in the area of the injection, you should call us immediately.