Discogram?

I phoned the MD who gave me epidurals last year (which didn't help), inquiring about trigger point injections.

I just got a call from his nurse who said that the MD would rather do a discogram. I'm inclined to say no and would like some feedback.

My MRIs clearly show disk damage, neuroforamen narrowing, etc. from C4-T4. Most likely, a few levels are responsible for my pain and if I am absolutely against surgery, for what reason would a discogram be relevant? It might be able to identify some details at some levels that are missed by the MRI.

But if I'm not going to have surgery unless the pain gets far far worse, it seems to me that the further information, though I'm curious, is not risk the time, burden, pain, expense.

From what I've read, discograms can be very painful. I'm very busy and I just don't think I can at this time burden my wife. Also, though I have good insurance and can't be dropped (as I'm on a group plan through a large employer), I want to be fair to them. I've had an ER visit this year that cost $7000 -- about which I am terribly embarrassed (I just couldn't tolerate my vertigo one evening -- before it was diagnosed -- and was desperate for help and answers). I assume the discogram will cost $3000-$5000. If it isn't going to be used for a surgical decision, then it is not fair to the insurer.

I can't talk this over with my GP for he's the sort to tell me to just go with what the specialists suggests.


Am I missing something about the discogram? Am I right that it is very painful?

Thanks.

Hi, Cogito,
I had a discogram prior to my L4-S1 fusion surgery (which failed, BTW, to help my pain). Chartreux makes a good point when she says it's a controversial test. I have never heard it suggested for anything but in advance of surgery. And it can be risky.

I'm not sure if they still do what was done to me, but they inject dye into the disk spaces that are problematic to get more information (and I'm not sure they really gained anything from mine as one disk space was already too narrow to get a needle into). But they also used (and maybe still do) to inject a "control" disk - one which was above or below the problematic disks, just to compare your response. You need to be conscious (although it's conscious sedation) to give feedback to the doctor while he/she is doing the test. It wasn't fun, but we're generally in so much pain I think we forget that we tolerate these procedures better than the average person!

I'd suggest doing some research and see if the procedure is even still recommended, but if you're not having surgery then I'd wonder why a doctor would want to do the test. There is some risk as the disk space gets punctured, and the research I read after my procedure indicated that they no longer recommended injecting a "control" disk because it might just damage a good disk.

I'd go with your thinking on this.

Good luck.

PaLady

          Good afternoon Cogito!

                I have had a discogram, and was done just prior to my double lumbar fusion surgery. Sedation was used, but I was kept awake, so that I could comfirm the pain in each disk that they tested. There was no or little pain as they started, but when they injected the disk, the pressure buildup caused me to moan a few times.

      I have to agree with the rest of the members here, and do not understand why they are doing this test, unless they are getting ready for surgery.

       Let us know, what comes out of the meeting with your Dr,

           Take care,

       SE

Hi,

Brief update:

I went to see a new GP today, who was great. My previous one would rush through, and seemed just apathetic. This guy spent 45 minutes with me. He asked a lot of questions, was clearly happy with his career and committed.

Regarding the discogram, he said first that the MD should have had me come in, reviewed my MRIs, etc. discussed treatment options, etc. before jumping to a discogram -- ad the GP put it, it is like calling an auto mechanic because your car is making a noise and their recommending a new transmission. The GP added that there are only a few very specific pathologies for which a discogram is needed and as a final step before possible spinal surgery.


So, he's referred me to a different interventionist PM doc.

So very glad you were able to talk with your gp first...
Many well wishes with your new PM doctor...Keep us posted on how that
goes...