A provocative discography, also known as a diagnostic discography, is a medical imaging procedure used to evaluate the condition of the intervertebral discs in the spine.
The primary purpose is to determine if a specific disc is the source of a patient's back pain. This is particularly useful in cases where other imaging tests (like MRI or CT scans) have not provided a clear diagnosis.
TIt helps in planning spinal surgery by identifying which discs are problematic.
It evaluates the structural integrity of the discs.
The results can be crucial for planning the management of low back pain by latest and most advanced Interventions like INTRADISCAL COOLED RFA/ BIACUPLASTY. This procedure can HELP IN AVOIDING spinal surgery in many patients.
The patient will be instructed to avoid eating or drinking for a few hours before the procedure. They may also need to stop taking certain medications.
The patient lies on a table, on their stomach.
Local anesthesia is administered to numb the skin and tissues around the injection site.
Using fluoroscopic guidance (real-time X-ray), the doctor inserts a thin needle into the disc in question. Multiple discs may be tested during the same session.
A contrast dye is injected into the disc. This helps visualise the disc on X-ray and assess its internal structure.
The patient is asked to describe any pain experienced during the injection. This helps to determine if the disc is the source of the pain.
Additional imaging may be done to assess the spread of the dye and the disc’s internal structure.
The procedure can be uncomfortable and may reproduce the patient’s usual back pain. This reproduction of pain is a critical part of the diagnostic process.
The procedure typically takes about 30-60 minutes, but patients should plan to spend a few hours at the medical facility for preparation and recovery.
Some soreness at the injection site is common. Patients are usually advised to rest for the remainder of the day and avoid strenuous activities.
The doctor will discuss the results and potential next steps, which may include further diagnostic tests or treatment options such as physical therapy, medication, or surgery.
There is a small risk of infection at the injection site.
Minor bleeding or hematoma formation may occur.
Rarely, the procedure may cause nerve damage.
There is a slight risk of an allergic reaction to the contrast dye.
A provocative discography is a valuable diagnostic tool for patients with unresolved back pain, providing critical information that can guide effective treatment plans. Understanding the procedure and knowing what to expect can help alleviate some of the anxiety associated with this diagnostic test.