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discogram need input please

starsinhereyessstarsinhereyes Posts: 583
edited 06/11/2012 - 8:43 AM in Lower Back Pain
hi fellow spineys
just came from spine doc again...my legs have gotten worse and pain is intense..
he now wants me to get a discogram..i have had so many test and had a mylegram just month ago
bone scan, mri's m
ct flexion x-ray all show issues with l5,s but not showing which disc exactly..have bulging disc above ..
i'm so confused ..if all these test not pin pointing problem ..would a discogram show something more..
just having another procedure scares me..altho other test not showing enough for doc i'm not sure..thats what he thinks all these test are missing something..
sorry rambling..has anyone had a myelogram and a discogram they sound to me about the same..
please any input would be so helpful..
i also have fibromyalgia and he doesn't think my severe pain in legs from a bad flare up..he seems very concerned..
thanks ppl
god bless you
neck,bone spurs pain started 04, back issues and fusion l4,l5 06~hardware removed.
good few yrs. 09 pain sharp, numbness feet,legs, diagnosed fibro, neurop. legs.lung issues.
daily goal do good thing for someone.


  • Myelography and discography sound similar, but there are subtle differences. A myelogram is done when material is injected into the subarachnoid space. It is designed to look for conditions that affect the spinal canal, looking at the spinal nerves and blood vessels that run into the central canal.

    Discography uses a similar procedure but the discs are injected rather than putting the "dye" into the subarachnoid space. The discs are "pressurized" so that if there are any tears or leaks in the discs themselves, the liquid will leak out from the disc. The doctor will inject the suspected discs and a healthy one for control purposes. The procedure is somewhat subjective as the patient needs to report when and if there is pain at the time of injection.

    Discography is often performed when the doctor cannot tell from the MRI which disc or discs is/are the pain generator. The surgeon does not want to perform surgery on the wrong disc.

    If you run a search on the forum for discogram, you can find many discussions over the procedure, what it entails, whether it hurts, etc.
  • Mary, I`ve had those test, they were all needed. I feel the result of my surgery depended on the Discogram. It helped my NS. determine the discs. that was causing the pain in my legs,butt,and lower back pain. It was most likely the most painful test, but it did show him the discs. that was causing the leg pain. I hope this helps you in some way! Good luck, you`ll make the right decision. Brenda
  • Mary I hope all these tests help the doctor to tell you what is wrong. Sorry I haven't had either but hope it helps.

    Good luck and my prayers are with you.

  • Based on the limited info you provided, it sounds like a discogram is a very logical next step. The discogram, unlike imaging, actually reproduces pain so it can be a much better indicator of which disc is causing the trouble. Sometimes discs can look bad on MRI's and not be symptomatic, so the discogram will help differentiate anatomic abnormalities from a true pain generating structure.

    On a more personal note, I had a discogram that found a problem disc that had been missed on my MRI. So, it is possible for discograms to pick up on disc problems that are missed on other imaging studies, or in your case to give a clearer picture of what exactly the disc problem is.

    From your post it sounds like you just need some reassurance that a discogram makes sense? Given your symptoms, it seems like a reasonable next step (of course, I'm not a doctor so this is definitely something to discuss with your doctor). I would guess that if you voice your concerns he will be able to better explain *why* he thinks you need the discogram and this will hopefully help you decide whether it is the right next step for you to take. It is an invasive and uncomfortable procedure that carries risks, so you do need to make sure that you are 100% ok with it before moving forward.
  • In my limited experience this was the last procedure my surgeon did prior to operating on me. He wanted to know exactly which discs were causing the real problem as some of mine were "unclear" on the last MRI scan. As it has been said by others this is an invasive procedure which will cause discomfort or pain but you will be fairly heavily sedated, but by the same token you need to be able to respond to the surgeon when prompted by questions. In the UK this tends to be done in a main theatre with a full team of staff including radiographers as they will be taking real time xrays and locating where the dye etc is leaking from. I am a little weird in that I like to be able to see what is going on and being part of things and quite often I asked for the screens to be turned around so I could also see what was happening as they were doing things!! LOL The more I know and understand things the better I can accept it!!
    I hope things go well for you.
  • I had a discogram (discography) performed at the request of my doctor. He felt that the results clearly indicated one disk was causing me pain. A different disk also generated significant pain during the test but it was different than anything I had felt before. A third disk, the control disk, just felt pressure, but no pain at all.

    I have read in multiple places that some doctors are skeptical about the reliability of the results (I'll try to find actual links, but the anesthesiologist who did the procedure actually provided that statement in a written disclaimer that I had to sign)because it relies heavily upon the patient's accurate assessment of "is the pain being generated by the test replicating the same pain that you normally feel?". Your answer to that question is critical to the ensuring useful test results.

    Someone mentioned sedation, but I disagree with that, at least in the US. They don't want you sedated because they want to ensure that you are feeling the real pain being generated by any bad disks. Thus, the test can be really tough.

    They may then follow up with a CT Scan using reactive dye in order to see the internal structure of the "bad" disk(s).

    This test is just one more tool for a doctor to assess what is causing your pain. I'm on the fence as to whether or not the fusion I had 14 weeks ago was actually the right solution to my problem, because I have the same pain now as before surgery.
    Even so, I would always suggest folowing your doctor's advice and do whatever tests they prescribe. However, you need to take ultimate responsibility for your own health, so it's good to read upon on things and keep asking questions.

    Best wishes!

  • Dave, I'm so sorry to hear that you are second guessing your fusion. I had one microdisc a year ago and two months later started developing similar butt, leg, foot pain in opposite side. New mri's show nothing and second NS said discogram and probably fusion (L5/S1). I'm now just trying to live with this but it really is a drag. I pray that you start to feel better. Jon
  • I had discogram 4/8/10 and it was very very painful. That being said my NS said it would really help him pinpoint the exact disc or discs causing my issues. Well 3 weeks later and we are still not sure. (my results were not so cut & dry 4 discs tested) NS is now sending me for consult with spinal specialist ortho. I was not sedated for the test, i felt a lot of pain and was well aware of it - I am not saying this to scare you but just making a point, the test is subjective and is meant to inflict pain to diagnose. If your doc is suggesting this test you must need it. I guess like everything else there are a lot of variables. I wish you all the best.
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