Diagnostic Diskography

A diagnostic diskography is a test to help find the cause of serious back or neck pain. It can tell if the pain is coming from a disk in the spine.

The spine, sometimes called the backbone, is made up of bones called vertebrae. They support the body. They also protect the spinal cord (nerves that carry messages to and from the brain). Between each vertebra is a disk. The disks are oval in shape. Inside is a thick liquid which functions as a spongy cushion. The disks keep the bones from rubbing against each other when you move. Sometimes there are problems with the disks. For example:

  • An injury can cause a disk to tear open and the fluid leaks out. This can irritate the nerves which causes pain.

  • Sometimes a spinal disk loses liquid over time. Normal wear and tear can cause this. Then, the vertebrae get too close together, which puts pressure on the nerves and pain results.

  • A disk can bulge out between the vertebrae. If the disk then presses on a nerve it will cause pain. This is called a herniated disk. An injury or wear and tear can cause it.

The pain from a disk problem might be in your back or in your neck. Pain could also shoot down into an arm or leg. Sometimes there is tingling, weakness, or numbness too.

Imaging tests might show disk problems, such as an MRI. A diagnostic diskography can pinpoint which disk is really causing the pain.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any allergies.

  • Any allergic reaction to X-ray dye or iodine.

  • All medicines you are taking, including:

  • Herbs, eyedrops, over-the-counter medicines, and creams.

  • Blood thinners (anticoagulants), aspirin, or other medicines that could affect blood clotting.

  • Use of steroids (by mouth or as creams).

  • Previous problems with anesthetics (medicines that block pain).

  • Possibility of pregnancy, if this applies.

  • Any history of blood clots.

  • Any history of bleeding or other blood problems.

  • Previous surgery.

  • Smoking history.

  • Any recent symptoms of colds or infections.

  • Any history of diabetes or seizures.

  • Family history of anesthetic problems.

  • Other health problems.

RISKS AND COMPLICATIONS

Problems after a diagnostic diskography do not happen often. However, they could include:

  • Pain. It sometimes gets worse right after the procedure. This should last only a short time.

  • Infection. This can develop in the disk space. That can be very painful. Antibiotic medicines would need to be taken to get rid of the infection.

  • Bleeding.

  • Injury to a spinal nerve.

  • Allergic reaction to the contrast material.

  • Seizure.

  • Headache.

  • Nausea.

  • Herniated disk.

BEFORE THE PROCEDURE

  • A medical evaluation will be done. This will include:

  • A physical exam.

  • Imaging tests of the back. This could include X-rays, computerized X-ray scans (CT or CAT scan), or computerized magnetic scans (MRI).

  • You will need to stop taking certain medicines.

  • Stop using aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. This includes prescription medicines and over-the-counter medicines. If possible, do this 10 to 14 days before the procedure. Also, stop taking vitamin E.

  • If you take blood thinners, ask your caregiver when you should stop taking them.

  • The person having a diagnostic diskography needs to give informed consent. This requires signing a legal paper that gives permission for the procedure.

  • The night before your procedure, do not eat anything after midnight. Sometimes, you can have clear fluids at breakfast time. Talk to your caregiver for specific instructions.

  • Make plans to have someone drive you home after the procedure.

PROCEDURE

  • The preparation:

  • Small monitors will be put on your body. They are used to check your heart, blood pressure, and oxygen level.

  • You will be given an intravenous line (IV). A needle will be inserted in your arm. It is hooked to a plastic tube. Medicine will be able to flow directly into your body through the IV.

  • You probably will be given a sedative. This medicine will help you relax.

  • You will lie on your side on the examining table.

  • The area of the back that will be tested will be cleaned with a solution to kill germs on the skin.

  • The procedure:

  • You will be given a shot of anesthetic in your back. This is a medicine that will make the area numb. It will be given over the disks that will be tested.

  • A long hollow needle will be put through the skin and muscle until it reaches the disk.

  • A type of X-ray (fluoroscopy) will be taken. This checks the position of the needle.

  • A second needle will be put through the hollow needle. It will go into the center of the disk that is being tested.

  • A fluid that shows up on an X-ray (contrast) will be injected into the disk.

  • Then, the pressure inside each disk can be measured.

  • You will be asked if you feel pain. You may be asked to compare any pain to the back, neck, leg, or arm pain you have had.

  • A CT scan will be done. This shows if any contrast fluid is leaking from the disk.

  • The procedure usually takes less than 1 hour.

AFTER THE PROCEDURE

  • You probably will stay in a recovery area for about 30 minutes. Your blood pressure and pulse will be checked.

  • Some pain after a diagnostic diskography is normal. You may be given pain medicine while in the recovery area.

  • When you are alert and recovered, you will be able to go home. Someone will need to drive you.

HOME CARE INSTRUCTIONS

  • Pain may be greater for 1 to 2 days after a diagnostic diskography. Muscles might be sore, too.

  • Take whatever pain medicine has been prescribed by your caregiver. Follow the directions carefully. Do not take over-the-counter pain relievers unless your caregiver says it is okay.

  • Putting ice packs on the area 2 to 3 times a day may help ease the pain.

  • Do not drive if you are taking narcotic pain medicines.

  • You can start going back to your normal activities after 1 to 2 days. Do so gradually. When you can return to work will depend on the type of work you do. You will need to take it easy for a few days.

  • Be sure to keep all follow-up appointments.

SEEK MEDICAL CARE IF:

  • You have any questions about medicines.

  • Your pain continues even after taking pain medicine.

  • You have severe, increasing arm or leg pain.

  • You have difficulty controlling your bladder or bowel.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your pain suddenly gets much worse.

  • You have a fever.