Background Information:

What are the other Names for the Procedure?

• Disc Stimulation
• Discography
• Diskogram

What is Discogram radiology procedure? (General Explanation)

• A Discogram is an imaging test to detect intervertebral disc problems such as back pain
• Intervertebral discs are shock absorbers - a cushion-like material between the vertebrae, spine, and bones
• A bulge of the intervertebral disk may cause pressure on neighboring spinal nerves, resulting in pain

What part of the Body does the Procedure involve?

The Discogram procedure involves the spine.

Why is the Discogram radiology procedure Performed?

A Discogram is used to probe into the cause of back pain and to detect any abnormal intervertebral discs.

What is the Equipment used? (Description of Equipment)

The Discogram procedure includes the following equipment:

• A radiographic table
• A computer monitor
• An examination table
• A CT scanner
• An X-ray machine

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Discogram procedure.

What is the Cost of performing the Discogram radiology procedure?

The cost of a Discogram procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Discogram procedure and what needs to be done

If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician

Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=discography (accessed on May 7, 2015)

Prior to Discogram radiology procedure:

How does the Discogram radiology procedure work?

• X-rays are passed through the patient’s body and recorded on a recording plate on the other side of the body
• Various parts of the body absorb different amounts of radiation, and these show-up differently in shades of gray or black on the plate
• Fluoroscopy uses X-ray beams and creates images on the monitor

How is the Discogram radiology procedure Performed?

• The patient is positioned on the examination table and an intravenous (IV) line is inserted into the vein
• Their blood pressure, heart rate, and pulse are monitored. The patient is administered local anesthesia
• A needle is inserted through the skin into the center of the intervertebral disk being examined, using imaging guiding tools
• The contrast material is injected when the needle reaches the center of the disc; after which, the needle is removed
• The vertebral disc is examined using real-time imaging produced by fluoroscopy and by taking several images
• The Discogram procedure may be repeated if more than one intervertebral discs are being examined

Where is the Procedure Performed?

A Discogram is performed as an outpatient procedure at a hospital.

Who Performs the Procedure?

An interventional radiologist performs the Discogram procedure.

How long will the Procedure take?

A Discogram procedure usually takes about 30 minutes.

Who interprets the Result?

An interventional radiologist interprets the results of a Discogram procedure.

What Preparations are needed, prior to the Procedure?

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are currently being taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, or to the anesthesia, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
• It is highly recommended to inform your healthcare professional if you are pregnant or breastfeeding
• The patient may be asked to avoid eating or drinking several hours before the test
• The patients may be required to be driven home after the procedure

What is the Consent Process before the Procedure?

A physician will request your consent for a Discogram procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Discogram procedure:

• The procedure is minimally invasive
• No radiation remains in the patient’s body after the procedure
• The CT scan is noninvasive, accurate, and provides detailed images

Following are the risks of the Discogram procedure:

• There is a slight risk of infection
• The contrast material or anesthesia may produce an allergic reaction
• The CT scan is generally not used if the patient is a pregnant woman
• It is recommended that mothers breastfeed their children (at least) 24 hours after the contrast material is injected
• There is a chance of spinal nerve damage, bleeding, or paralysis
• In some cases, the back pain may worsen after the procedure

What are the Limitations of the Discogram radiology procedure?

Following are the limitations of the Discogram procedure:

• The procedure is only used if conservative therapies fail to decrease the back pain
• In some cases, CT or MRI scan may give a more accurate diagnosis than a Discogram procedure

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Discogram procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required after the procedure is performed?
• Are there any follow-up tests or periodic visits to the healthcare facility required after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Discogram radiology procedure:

What is to be expected during the Discogram radiology procedure?

• During a Discogram procedure, the patient may feel slight pain when the intravenous (IV) line is inserted
• They may also feel a warm sensation when the contrast material is injected

What kind of Anesthesia is given, during the Procedure?

The patient is administered general anesthesia during a Discogram procedure.

How much Blood will you lose, during the Procedure?

The Discogram is a minimally invasive procedure; it involves little or no blood loss.

What are the possible Risks and Complications during the Discogram radiology procedure?

The possible risks of Discogram include:

• There is a slight risk of infection
• The contrast material may produce an allergic reaction
• A CT scan is generally not used if the patient is a pregnant woman
• Breastfeeding should be resumed only after 24 hours of contrast material injections
• There is a chance of spinal nerve damage, bleeding, or paralysis
• The back pain condition may worsen after the procedure

What Post-Operative Care is needed at the Healthcare Facility after the Discogram radiology procedure?

• There is no postoperative care necessary at the healthcare facility after the Discogram procedure
• However, if no abnormal intervertebral disc is detected during the procedure, the patient should discus with the physician about other potential causes of back pain

After the Discogram radiology procedure:

What is to be expected after the Discogram radiology procedure?

The patient may feel pain at the injection site after the Discogram procedure. Ice packs may help alleviate the pain, in such cases.

When do you need to call your Physician?

• If the pain after the Discogram procedure does not subside with ice packs or pain medications, then the patient could contact their physician
• If the patient experiences fever, nausea, or vomiting after the procedure

What Post-Operative Care is needed at Home after the Discogram radiology procedure?

• If the patient experiences pain, then ice packs over the injection site and pain medications are recommended
• Apart from this, generally there is no post-operative care necessary after the procedure

How long does it normally take to fully recover, from the Procedure?

Recovery from the Discogram procedure usually takes about 24 hours.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue sample is taken during the Discogram procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Discogram radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• A radiologist performing the procedure
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Discogram procedure is performed.