Discograms:  To Do or Not to Do, What are the Pros and Cons?


Frequently, before a doctor decides to perform surgery on a patient he or she suggests a discogram, a test used to evaluate back pain. During a discogram x-ray dye or contrast material is injected into the discs of the spine. After the dye is injected, an x-ray is taken of the discs. Many doctors believe a discogram can be used to determine if a patient is a good candidate for surgery. Others feel it is a painful procedure and opt simply to recommend surgery based on other factors.

Many doctors feel it is necessary to have at least one control level that is negative when evaluating whether a discogram is a good piece of medical evidence to use in determining the treatment for the patient.

There is much debate regarding the usefulness of this diagnostic test considering it is a painful procedure that isn't always accurate in its results. However, surgery is an invasive procedure and could possibly have negative outcomes, therefore many surgeons insist on this test to evaluate whether a patient is a surgical candidate. As with any other invasive test, there are associated risks and possible complications including disc space infection, nerve root injury and spinal headache, even though these are all very rare. It is more common for a patient to have a failed back surgery which could be prevented if the discogram showed a patient would not be a good surgical candidate.

In summary, to do or not to do is always the preference of the doctor and/or of the patient. In New Jersey, if your authorized treating doctor has ordered this test, absent a second opinion from a respected spinal surgeon, you need to consider it so the doctor can evaluate whether surgery is necessary. If you want a discogram prior to surgical consideration, you should keep this in mind when picking a physician.

By: Jennifer Laver

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