Discography is a diagnostic tool to evaluate the exact source of pain. All of your questions and concerns should be addressed and answered. It is the first step patients must undergo before treatment can begin, as this discogram can reveal exactly where the damage is on the spine, as well as the severity of the damage. When the pain is thought to be discogenic and is located in the lumbar spine a discogram of this region is often helpful to pinpoint the origin of the pain. Our medical system has never been perfect but back in the early 90s and prior, health insurance was a fairer propostition with insurers claiming only a reasonable share of the profits, not all. Intervertebral discs are found between the vertebrae the bones of the spine. Mar 17, 2008 lumbar discogram information i am set up to get a lumbar discogram soon, i have declined the spinal fusion surgery and i was just wondering if the discogram was still necessary. Sedation was used, but i was kept awake, so that i could comfirm the pain in each disk that they tested. It is designed to reproduce pain in an awake patient to prove the source of pain or the pain generator.
The lumbar discogram is a provocative test, which reproduces the pain while you are awake. Home for health care providers interventional pain treatment lumbar pelvis procedure lumbar discography position and anatomical landmarks the patient lies in the prone position on an xray permeable table with a pillow under the abdomen to flatten the lumbar lordosis. If you do not experience pain not as awful as it might sound at the time of the discogram, it indicates that the pain symptoms you are experiencing are not confined to the intervertebral discs themselves but may be related to other degenerative changes of the spine. I have had both mylegram and discogram and my neuro said the discogram is a last resort test, and will only put his patients through this pain after a positive healthboards bone joint muscle back problems. Cash prices published on this site apply only to patients who pay the entire fee in advance. Why would you have a myelogram and not a disco gram first. The discogram seems much less invasive and less painful. This is the companion video to explanation of microdiscectomy for lumbar disc herniation and leg pain. Test is to find the source of your pain by recreating it over the same location with the same quality as the disc is injected. This video provides complete information and diagrams on discography. It can help a pain doctor, orthopedic spine surgeon or neurosurgeon determine whether or not one of a patients intervertebral discs is the source of an individuals back pain. Use discography cpt code 72295tc for the radiology supervision and interpretation performed in the lumbar area.
Derby et al completed a multicenter retrospective study of longterm surgical and nonsurgical outcomes after lumbar discography in 96 patients. It is usually ordered by spine surgeons in order to determine if a patients severe axial low back pain is caused by their lumbar disc disease internal disc derangement seen on mri. The single level discogram illustrates the normal morphology of the lumbar disk. Subscribe to channels you love, share with friends, and watch on any device. Whats the recovery time after a discogram what will. Here are the most common reasons to undergo discogram test.
During a discogram of the lumbar spine, needles are placed into the l34, l45, and l5s1 discs. Patel and sudhir diwan introduction discography has been practiced by interventional pain physicians for the last few decades in an attempt to identify the pain generator in the lumbar or the cervical spine and less commonly the thoracic spine. The best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. Please call 18889990410 for custom sizing and other options.
After positive lumbar discogram, patients underwent interbody fusion alone, combined fusion, intertransverse fusion, or no surgery. Anterior lumbar interbody fusion alif low back pain. While different discographers may vary the procedure slightly, the following provides an overview of modern technique for a lumbar discogram diagnosing back pain. The patients citation of pain is often used to justify the conclusion that the injected disc is indeed the sole or primary cause of existing pain, which is often a highly incorrect assumption. The use of prophylactic antibiotics has been advocated, although there is great concern regarding their efficacy. The disc is a unique structure between the vertebral column that bears the weight and allows the movement of spine. The disc is then injected with contrast material, i. Although this procedure was initially intended to identify a pain. Discogram imaging glossary patients ur medicine imaging. It was authored by david fardon, md, and pierre milette, md. Get the official youtube app for android phones and tablets.
If pain worsens or changes it could be discogram procedure caused a disc to herniate or herniate further. Lumbar discography the pain source makes learning about. Apr 24, 2007 for example, if a physician performs a discogram at levels l12, l23, and l34, bill code 62290 on the claim form three times. I have had both mylegram and discogram and my neuro said the discogram is a last resort test, and will only put his patients through this pain after a positive.
Position and anatomical landmarks the patient lies in the prone position on an xray permeable table with a pillow under the abdomen to flatten the lumbar lordosis. Click to enlarge image this is a front to back view ap of the discogram at l34, l45 and l5s1. For instance, if an individual is experiencing low back pain with an mri showing disc degeneration at l4l5 disc space, the discogram can confirm whether or not that is where a. The discogram is the only spinal test that is provocative. A discogram is a very advanced test that is extremely operator dependent. Lumbar discography discogram diskogram is a diagnostic procedure performed by fellowshiptrained interventional pain physicians. The pain is replicated only for an instant and if pain is reproduced, the patient can identify if the pain is the typical pain that occurs from day to day. A lumbar discogram is a diagnostic procedure that is performed to help find the cause of your chronic back and leg pain. Procedure lumbar discography universitair pijn centrum. Lumbar discograms lower back pain diagnosis colorado. Nonsurgical back pain diagnostic procedure discography also called a discogram is a diagnostic procedure used to determine if one or more discs are the cause of back pain. Again, the black arrows point to the top two normal discs l35 and the bottom white arrow points to the disrupted l5s1 disc. The discs in the lumbar spine form cushions between the vertebrae of the lumbar spine. May 14, 2018 the purpose of a lumbar discogram is to give the provider and patient more information about the health of the lumbar discs.
A discogram also known as a discography is a diagnostic tool used to determine whether certain discs of the spine are the source of a patients neck or back pain. Provocative discography is performed in the operating theatre under strict sterile conditions. The rates of falsepositive lumbar discography in select patients without low back symptoms. I am set up to get a lumbar discogram soon, i have declined the spinal fusion surgery and i was just wondering if the discogram was still necessary. Lumbar discography is not a treatment in itself, merely a diagnostic tool.
Nov, 2007 lumbar postdiscography discitis resolves in 811 weeks while cervical discitis resolves in 67 weeks. Disc disease indications presurgical fusion postsurgical fusion preintradiscal electrothermal therapy or percutaneous disectomy. Is it used only for surgery information, or is it just to find out more info on the problem. If the disc is the source of the pain, there are some potential treatments available to the patient. A discogram of the lumbar spine, also called lumbar discography, is a pain management procedure that serves a valuable diagnostic purpose. Lumbar discography can be used in the diagnostic workup of degenerative spine disease. Sep 08, 2016 derby et al completed a multicenter retrospective study of longterm surgical and nonsurgical outcomes after lumbar discography in 96 patients. The procedure involves pressurizing discs by injecting them with a sterile liquid to induce pain in the affected discs. It is usually ordered by spine surgeons in order to determine if a patients severe axial low back pain is caused by their lumbar disc disease internal disc derangement seen on mri the suspected diseased and painful discs are. This procedure is useful when trying to decide if the disc in the lower. With a new design, you can have fun exploring videos you love more easily and quickly than before.
It is made of the nucleus in the middle and fibrous tissue surrounding it. It is usually reserved for persons with persistent, severe low back pain lbp who have abnormal spaces between vertebrae on magnetic resonance imaging mri, where other. The purpose of a lumbar discogram is to give the provider and patient more information about the health of the lumbar discs. A discogram is an invasive test procedure that is not generally used for an initial evaluation of back pain however, a doctor can suggest a discogram if your back pain continues despite treatments, such as medications and physical therapy in some cases, doctors use a discogram before spinal fusion surgery to help identify which. The pain management doctors at tulsa pain consultants will use a. The most serious complication is discitis, believed to be due to penetration of the disc by a needle contaminated with skin flora. One of these treatments is called an idet or intradiscoelectrothermalannuloplasty which is a big term for simply threading a thin filament into the disc and. This xray which is also called fluoroscopy is used to guide the procedure.
This can lead to symptoms such as back, hip, buttock and leg pain. Spine procedures mis, discogram mis prices prairie. Lumbar discography pre procedure clinic visit preferred but not needed if referring physicians clinical evaluation is adequate. An anesthetic is used to numb the skin and deeper tissues, so you may feel a pinch and slight burning. A nurse or other healthcare professional conducts the initial interview. A discogram is a procedure where a needle is placed into a spinal disc in the back. If your physician is suspecting a disc to be the pain generating area in your back, a discogram may identify this more clearly. Patients who have disabling low back pain, neck pain, and arm or leg radiation pain should consider discograms, discographys, especially when other conservative diagnostic methods and. Discography also called a discogram is a diagnostic procedure used to determine if one or more discs are the cause of back pain. The spine journal, volume 3, issue 3, supplement 1, mayjune 2003, pages 1127 richard d. Video of l5s1 surgery lumbar microdiscectomy low back.
A lumbar discogram is a diagnostic procedure used by the attending orthopedic spine surgeon to determine the intervertebral discs that may be causing back pain for patients. Top spine procedures mis discogram mis procedure service. One way to decrease the risk of discitis is to perform the procedure with a double needle technique. Provocative discography in patients after limited lumbar discectomy a controlled, randomized study of pain response in symptomatic and asymptomatic subjects. Five or in some cases, six vertebrae make up the lumbar spine, which provides support for much of the upper body and is rather flexible. The third lumbar spine vertebra l3 is located in the.
Please look at all of the spine related videos on youtube for neckandback. A lumbar discogram is an outpatient, invasive procedure used to evaluate the condition of the disks in the lumbar portion of the spine and determine if these disks are the cause of back pain. Lumbar provocative discography also referred to as discography or discogram is an invasive diagnostic procedure for evaluation for intervertebral disc pathology. Aug, 2014 the best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. The discogram creates an exact image of the discs to help identify and confirm the actual cause of pain. The pain is mild, much like the typical disc pain the patient has during everyday activities. A discogram refers to a procedure commonly used in the lumbar spine but also in the cervical spine neck. I am a 62 year old school teacher who recently had a discogram on my lumbar spine. Also, just wondering if anyone has had one, i hear it is pretty bad. Patients who have disabling low back pain, neck pain, and arm or leg radiation pain should consider. For instance, if an individual is experiencing low back pain with an mri showing disc degeneration at l4l5 disc space, the discogram can confirm whether or not that is where a persons back pain is coming from. A discogram is a diagnostic procedure which gives very important information to the doctor treating you. Anterior lumbar interbody fusion alif anterior lumbar interbody fusion, also known as alif, is an operation primarily performed for the treatment of low back pain. I have had a discogram, and was done just prior to my double lumbar fusion surgery.
Occasionally it triggers typical episode of exacerbation of pain which for a small percentage can last 25 days. A disc that is unable to pressurize during a discogram is possibly ruptured. A discogram is a tool to confirm whether or not the patients back pain is coming from a particular disk space. Whats the recovery time after a discogram what will help. Surgical video of l5s1 lumbar microdiscectomy goes over the anatomy and technique of lumbar microdiscectomy in an easy to understand stepbystep manner. Lumbar postdiscography discitis resolves in 811 weeks while cervical discitis resolves in 67 weeks. Thirty minutes before the intervention, the patient receives antibiotics 2 g cephazolin, i. For example, if a physician performs a discogram at levels l12, l23, and l34, bill code 62290 on the claim form three times. Append modifier 59 to those codes billed subsequent to the first level to help avoid a payer denial.
Discogram testing is known to be incredibly painful, even in patients who have normal discs that are obviously not the source of any pain. If you are not given enough intravenous anesthesia, this can be obviously very painful when the needles are placed. See what the world is watching from the hottest music videos to whats trending in gaming, entertainment, news, and more. Chip fractures, commonly referred to as avulsion fractures, are a type of injury where small fragments of bones are chipped of the bones main structure. These discs can often become degenerated or worn out.