Lumbar Discogram (Discography)
A lumbar discogram is a diagnostic procedure that uses pressurization of the disc to determine whether a specific disc is the source of a patient's back pain. Unlike MRI — which shows structural changes — discography tests whether a disc is painfully symptomatic by reproducing the patient's exact pain during pressurization.
Why Discography Is Used
Many patients with chronic low back pain have disc degeneration visible on MRI at multiple levels. Discography answers the critical question: which disc is actually causing the pain? This information is essential for treatment planning, particularly before considering disc surgery, intracept procedure, or intradiscal treatments.
How the Procedure Works
Under fluoroscopic guidance, Dr. Rubin places a needle into the center (nucleus pulposus) of each disc being tested. The disc is then pressurized with contrast dye. A disc is considered positive (and thus painful/symptomatic) if:
- Pressurizing the disc reproduces the patient's exact familiar pain (concordant pain)
- The pain is rated moderate to severe in intensity
A control disc (an adjacent disc expected to be non-painful) is also pressurized and should produce no pain or only mild non-concordant sensation — confirming the reliability of the positive response.
What to Expect
The procedure is performed with light sedation to keep you comfortable during needle placement, but you must be able to communicate your pain response during the pressurization phase. You will be asked: "Does this feel like your usual back pain?" Your honest answer determines the diagnostic result.
Post-procedure soreness lasting 1–3 days is common and expected.
Who Needs a Discogram?
Discography is typically recommended when:
- Multiple disc levels show degeneration on MRI and the symptomatic level is unclear
- Surgical planning requires confirmation of a specific painful level
- Other treatments have failed and discogenic pain is the suspected diagnosis
Contact Us
Call 516-492-3100 to discuss whether lumbar discography is appropriate for your diagnostic workup.