The Discography is a test where a contrast agent is injected directly into the disc. It is used to distinguish between disco genes (i.e. disc-related) pain and the facet syndrome. The investigation is performed under fluoroscopy. With a CT taken later on, the disc will be evaluated more precisely i.e. which shares are degraded. On the other hand, the patient feels - if it is a disco genes pain - during the injection, because of local pressure increase, the typical back pain. This is also referred to as memory-Pain.
The contrast agent is injected into the soft core (nucleus pulposus). If it remains there, the fiber ring is intact and the disc healthy (green arrow). When the contrast medium is excreted into the fiber ring and this mainly happens in the back, because there the fiber ring is very thin, then the disc is weakened (yellow arrow). If the fiber ring is cracked at the front, then there is a serious disc damage and there is no more separation between the fiber ring and a soft core (red arrow).
The Discography is a test carried out often before deciding whether an artificial spinal disc will be implanted. In particular if, in MRI it looks like several disks are changed and responsible for the pain needs to be figured out; or if it is necessary to determine whether the pain really comes from the damaged disc or not or from the facet or sacroiliac joints (so-called ISG's syndrome). When the patient’s known pain can be triggered by a discography, it is an indication that the patient will benefit from an artificial disc.