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Discography: What is it & why do I need it?

A spinal fusion is a major operation, one in which the outcome can not be guaranteed. This type of surgery is therefore considered the last resort in the treatment of discogenic neck or back pain. When the point has been reached where surgery is being considered, a fusion will usually only be offered if your surgeon feels the origin of your pain has been identified, that there is a surgical solution for the underlying problem, and that there is an acceptable chance of success.

Plain X-Rays, CAT and MRI scans, myelograms and other radiological investigations demonstrate the anatomy of the spine, they do not show us where pain comes from.  It is also important to remember that degenerative changes are common and may not be the cause of your pain.  It is therefore important that we identify the origin of your pain so that an accurate assessment can be made of the likely benefits of the surgery being proposed.

Discography is a procedure in which a needle is placed into an intervertebral disc and fluid (a contrast medium or dye) is injected as shown.

Local anaesthetic is used to numb the skin where the needle is inserted. As fluid is injected into the disc you may be aware of no discomfort, a sensation of pressure or mild discomfort, or the type of pain you usually have.

It is important that you tell the doctor performing the injections exactly what you are experiencing when asked.

It is usual to inject several discs at the same time. This is done to ensure that all painful discs are identified.

Sedation is usually used to reduce your discomfort during the procedure. You will be awake enough to tell the surgeon what you are experiencing during the procedure, but you will usually have no, or very little, recollection of the procedure itself following its completion.

You should expect your usual symptoms to be aggravated by this procedure for several days. In some cases it may be necessary to remain in hospital overnight, but in most cases patients are able to leave hospital on the same day.

The results of the discography will assist your surgeon in advising you about the chance of success with a spinal fusion, and may also indicate your suitability for other procedures such as disc replacement or annular denervation (IDET).

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