You may receive a light sedative to help you relax during the procedure, however, you will need to be awake and able to answer questions throughout the procedure.. Discography is usually performed in a procedure room that has equipment for X-ray imaging of the discs as the test is performed. You will be asked to lie on one side and may be rolled slightly forward on a table. Pillows can be used to help you achieve the desired position. Your skin will be wiped at the site of the injection with a cleansing antiseptic agent.
The suspected diseased discs and suspected healthy discs will be tested. This is to make sure that healthy discs test negative and that if a diseased disc tests positive, that the result is considered reliable. Typically, the lowest two or three lumbar disc levels are injected. The health care provider may inject an anesthetic into the skin to reduce the pain of the needles passing through tissue. Typically, antibiotics are given intravenously before and after the procedure.
A needle is inserted through the skin and muscle and comes to rest on the outer layer of the disc. During the process of placing the needles, imaging studies called fluoroscopy (similar to X-ray) are used to help the health care provider see where the needles are located along the path to the disc. A second needle is generally passed through the first one and into the center of the disc. This process is repeated at each level that is to be injected. In some cases, the health care provider may decide to inject an additional level and will place needles at that location after the initial injections. Contrast (a liquid that shows up on X-ray), is injected into the center of each disc. The volume and pressure of the injected liquid is monitored. If the disc is normal, the contrast remains in the center of the disc. If the disc is abnormal, the contrast spreads through the tears in the disc and may also leak out of the disc. As each disc is injected, you will be asked if you are experiencing pain. If there is pain, you will also be asked if the pain is similar to your usual symptoms in terms of location and the type of pain you are experiencing. You may be asked to rate the intensity of the pain that the injection causes, if any. This procedure is repeated for each disc that is injected. The pain provoked by the injection should be temporary.
The injection procedure generally takes about 30 minutes. After the disc injections, you may be kept for observation for 30 minutes or more. It is advisable that you have someone drive you home. In some cases, pain from the injection can persist for several hours. There may be some residual muscle pain from passing the needles. If you experience intense pain, call your health care provider.