Discography is the injection of local anesthetic and dye injected into the disk. Discography is used to determine which disk level(s) is painful, and is usually used as a diagnostic tool for your surgeon. A minimum of two disks will be injected. If you have x-ray findings of disk problems at many levels you may need more disks injected.
The main risk of the procedure, though it happens less than 1% of the time, is diskitis. Diskitis is an infection in the disk that can lead to an infection in the spine. Every effort is made to prevent this from happening – antibiotics before the procedure, sterile technique, etc. There is also a chance of what is called a paresthesia – a shooting, “electric-shock” type pain. This generally occurs when the medicine is injected into the disk and more pressure is put on the nerve. This usually passes quickly but on rare occasion it continues. As with most procedures there is a remote risk of bleeding, infection, nerve injury, or allergic reaction to the medications used. Some short-term side effects may occur. If local anesthetic spreads to nearby nerves you may have weakness or numbness that can last for several hours. If this happens you may have to stay in the Pain Management Center until this resolves. You may have increased pain for a few days after the injection, including localized pain at the injection site.
Your skin will be numbed with a local anesthetic. This is usually felt as a stinging/burning sensation. Once the needle is in the disk, however, it may be painful as the medicine is injected as the goal of the procedure is to try to reproduce your usual pain.
You will need to arrive 1 hour before your actual injection time so that an intravenous can be started and an antibiotic given. (Let the doctor know if you have any allergies to antibiotics and/or dyes). It takes about 45 minutes for the antibiotic to get to the disk – you will wait in the recovery area during this time (you may want to have your ride keep you company or bring something you enjoy doing – reading, crocheting, etc). After signing a consent form and checking your blood pressure, the intravenous will be started and the antibiotic given. About 45 minutes to 1 hour later you will be escorted into the fluoroscopy (x-ray) room. You will be asked to lie on the table on your stomach. The back is cleansed with an antiseptic soap. Sterile drapes are placed. The skin is then anesthetized (numbed) with a local anesthetic. This is felt as a stinging/burning sensation. Using x-ray guidance the needle is advanced to the appropriate position (into the disk) and local anesthetic and dye are injected. You will be asked to let the doctor know whether or not this causes your usual pain. The needle will then be removed. This process will be repeated at as many levels as needed. Your skin will be cleansed and bandages will be applied. (The bandages can be removed on the next morning). Your blood pressure will be checked and you will be discharged to leave with your ride after M.D. authorizes your discharge.
You may NOT drive for the remainder of the day after your procedure. No heat is to be used on the injection area for the remainder of the day. No tub bath or soaking in water (pools/Jacuzzi, etc) for the remainder of the day.
If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.
ON THE DAY OF YOUR PROCEDURE, PLEASE DO THE FOLLOWING:
♦ Take all blood pressure pills & heart medications prior to the procedure with a sip of water at least 3 hours before your requested arrival time. Your vitals must be stable to have the procedure.
♦ Have a responsible person to take you home.
♦ Arrive at the requested procedure time. Please do not be late or your procedure may be cancelled.
ON THE DAY OF YOUR PROCEDURE:
♦ Do not take ANY of the following 5 days before your procedure: Coumadin
♦ Do not take ANY of the following 7 days before your procedure: Plavix
♦ Coumadin must be stopped prior to the injection. You must have a normal INR prior to the injection. Do not stop the drug by yourself.
♦ Eat or drink 6 hours before the procedure.
NOTE: YOUR PROCEDURE WILL BE CANCELLED IF:
- You have an active infection, flu, cold, fever, or very high blood pressure.
- You do not have a responsible driver to take you home, arrive late for your procedure, or unable to follow the medication / fluid restrictions.
Call the office at (513) 860-1039 for procedure related questions.