Medical Media Images

Friday, May 30, 2014

What is a Spinal Discogram Injection? Shown and Explained with Color MRI Images

A "Discogram" is a form of Spinal Injection which doctors perform to get more information about a patient's Spinal Disc. Spine Specialists often try to identify a specific Disc or Discs as the culprit of a patients pain, especially . MRI information about the patient's Spine can help narrow things down, however they only show the Anatomy of the Spine, rather than pinpoint a patient's pain. In some patients the information from the patient's history, physical examination and MRI does make the diagnosis, however in others there is still some uncertainty about which Spinal Disc if any is the culprit of the patient's symptoms. As an example, in some patients the MRI shows more than one abnormal Disc, yet only one Disc may require surgery.

In general, Discograms are performed by either a Pain Management Specialist (Anesthesiologist, Physical Medicine and Rehabilitation Specialist, Radiologist, etc.) or a Spine Surgeon. These doctors have special training in placing the needle into Spinal Discs and interpreting the results of the injection. Discograms can be performed for Discs in the Neck (Cervical Spine), Mid-Back (Thoracic Spine, and Low-Back (Lumbar Spine).

Lets take a quick look at the Anatomy of the Low-Back (Lumbar Spine) before we take a look at a Discogram of the Low Back. This Color MRI Image is Interactive. As you move your mouse cursor over the Image, Interactive Tags appear. Each Tag displays text which explains a specific part of the Image.



Color MRI Spine Image Lumbar Spine Anatomy
Interactive Color MRI showing the Anatomy of  the Low-Back (Lumbar Spine)


So, how is a Discogram done? After the Skin over the Spine is cleaned with Antiseptics, the Skin is typically anesthetized with a Local Anesthetic. A Discogram Needle is then placed into each Disc with the help of a "live" (second by second pictures) X-Ray machine (Fluoroscope). Typically, more than one Disc is targeted by the Discogram. The Needle is placed into a normal and at least one abnormal Disc. Once the Needle is properly placed and verified with the X-Ray machine, Contrast Dye (and sometimes Anesthetic) is injected directly into the Disc. The Contrast Dye is important since this allows the doctor to see the dye inside the Disc with the help of the X-Ray machine. A normal Disc collects the Dye in its Center without leakage, while an abnormal Disc may allow the dye to leak into the Disc's outer ring (annulus fibrosus) or entirely outside the Disc. The second important piece of information from the Discogram is whether or not a patient feels pain when the dye is injected into the Disc. If pain is felt, it is very important to know if this is the same pain a patient typically feels. This may point to this specific Disc as the culprit of the patient's symptoms. A normal Disc should not cause this type of pain during a Discogram injection. Another piece of information doctors sometime obtain from a Discogram is a pressure reading inside the Disc. The Disc pressure can also help in the determination of a Disc is abnormal. Lastly, some doctors inject an Anesthetic into the Disc at the end of the Discogram to see if a patient will get pain relief from this procedure.
All together then, Discograms are performed to find out if a specific Disc or Discs are responsible for a patient's pain which can help determine if a Disc Surgery could relief this pain.

Now let's take a look at some Color MRI Images of Discograms. The first Image shows a Normal Discogram from a side-view perspective of  the Low-Back (Lumbar Spine). Notice how the contrast dye stays in the center of the Disc. This Image is also Interactive.



Color Lumbar Spine Sagittal MRI Image of a Normal Discogram
Color MRI of a Normal Discogram of the Low-Back (Lumbar Spine) from a side-view perspective (sagittal)

The next Color MRI Image shows the same Discogram injection from a perspective of a slice across the Spine (cross-section). When you put this Image together with the one above, it will give you a 3-Dimensional perspective of the injection. This Image is also Interactive.


Axial Lumbar Spine Color MRI Normal Discogram
Color MRI of a Normal Discogram from a cross-section perspective (axial)
The next Color MRI Image shows an Abnormal Discogram. Notice how the contrast dye leaks backward into a Disc Herniation. This patient would likely experience back pain during the injection which can help guide the doctor. This Image is also Interactive.


Sagittal Color MRI Lumbar Spine Anatomy Abnormal Discogram
Color MRI Image of the Low-Back (Lumbar Spine) of an Abnormal Discogram

The last Color MRI Image shows the same information from the above Image in cross-section. This Image is also Interactive.

Axial Color MRI Image Abnormal Discogram
Color MRI Image of the Low-Back (Lumbar Spine) showing an Abnormal Discogram in cross-section
While Discograms are not a foolproof way to find out which Disc in the Spine is abnormal or painful, it can be a useful tool together with the history and examination of the patient as well as MRI Images. The hope is that this test can improve the likelihood of a successful Spinal Disc Surgery.

If you found this Blog Article useful, here are some other related Spine topics from the MMI Blog:
What is Sciatica? Shown and Explained with Color X-Ray and Color MRI Images
What is an Epidural Injection? Shown and explained with Color MRI Images
What is a Spinal Fusion Surgery of the Low Back (Lumbar Spine)? Shown and explained with Color X-Ray Images
What is a "Spondylolisthesis" of the Low Back (Lumbar Spine)? Shown and explained with Color X-Ray and Color MRI Images.
What is an Artificial Disc Replacement of the Neck (Cervical Spine)? Shown and Explained with Color X-Ray Images
Lumbar (low-back) Artificial Disc Replacements shown and explained with the help of Color X-Rays
Disc Herniations of the Low Back (Lumbar Spine) shown and explained with Color MRI Images


Color X-Ray and Color MRI Images and text like the ones featured in this Blog are available for Licensing for Websites and Publications at www.medicalmediaimages.com.
 
 
The Content of this Blog Including text and images are Copyright Medical Media Images
 
General Disclaimer
Medical Media Images does NOT dispense medical or legal advice. Our images, text and any content cannot be used for diagnosis or treatment of a medical condition. All Images and content are for information purposes only. You must consult with your physician if you need medical advice. Medical Media Images is not a substitute for medical advice.
 
 

 

No comments:

Post a Comment