What is a Provocative Discography?
- A provocative discography involves the injection of fluid into the intervertebral disc. These discs act as “shock absorbers” and are found between each vertebral bone. Normally these discs do not convey pain information when you move.
- The disc may become damaged due to a piece of disc material pressing on the nerve, or because the disc itself is damaged, rather than it compressing another structure.
- When a disc is damaged, there is ingrowth of nerves and blood vessels into the centre of the disc, resulting in pain on movement.
- A provocative discography is performed to determine the cause of your pain. This involves the injection of a small amount of dye and antibiotic into the disc or discs that are suspected to be causing your back pain.
- This procedure is always performed under X-ray guidance in the day surgery setting.
- It is expected that you will experience increased pain for 2 to 12 hours after the discography. This pain may persist for 2 weeks but generally the pain returns to its prediscography level in 4 to 5 days. You will most likely need extra pain relief over the first few days after the discography.
- After the discography you are generally escorted to Newcastle Radiology by a Nurse for a CT scan. This will take approximately 1 hour. You will return to the Day Surgery Centre following your scan and will be discharged from there shortly thereafter.
Prior to the Procedure
- All blood thinning products (except aspirin) must be stopped prior to your procedure. You will be advised by letter when to stop taking these medications at the time that your admission date is arranged.
- You are able to take your other regular medications with a sip of water on the morning of your procedure.
- If you are an insulin dependent diabetic you will always be at the beginning of the list. Please bring your insulin with you and it will be given to you following your procedure.
- Hamilton Day Surgery Centre staff will advise you of your fasting and admission times.
- You must not have anything to eat, drink, smoke or chew prior to your procedure.
- You will need to organise someone to drive you home after the procedure as you will not be able to drive for 24 hours after your procedure.
- Please bring your X-rays, MRI scans & especially your CT discography study with you to the procedure.
What Will Happen?
- You will be admitted to the day surgery by a nurse and you will be asked to change into a gown.
- The Anaesthetist will speak with you and place a cannula (plastic needle) into a vein in your hand.
- In the procedure room, you will be assisted to position on the procedure table on your abdomen with a pillow under your hips and abdomen.
- The Anaesthetist will give you some sedation into your vein.
- An X-ray machine will be used to determine where the Doctor will place the needles for your procedure.
- The procedure will take approximately 20 minutes to complete.
- Dye (Omnipaque) and antibiotic will be injected into the disc to determine if the disc is the source of your pain.
- You will be asked to report any pain or symptoms as this is done.
- Your feedback at this time is very important.
- Please be as specific as you can as to what you experience.
- After the discography, you will be placed on a trolley and taken to recovery, where you will remain for approximately 30 minutes.
- Upon your return you will be given something to eat and drink. If your pain is controlled you will be discharged with a carer.
- Gentle activity and rest is recommended in the first 24 hours following the procedure. You may then return to normal activity.
- You will experience increased pain for 2 to 12 hours after the discography. This pain may persist for 2 weeks but generally the pain is back to its pre-discography level in 4 to 5 days.
- On admission, the nurse will ensure that you have adequate pain relief at home. If not, they will organize a prescription for you.
- A nurse from HPC will telephone you 24 - 48 hours following your procedure to discuss the outcome of the procedure and organise a follow-up appointment.
If you require further explanation of the procedure, please contact Hunter Pain Clinic nursing staff on (02) 4985 1800.
* Image by BruceBlaus (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons