Medical Media Images

Thoracic Discogram Procedure

What does “Thoracic Discogram” mean?

Here is the meaning of each word:

  1. Thoracic: the part of our spine located in the mid-back
  2. Discogram: a procedure where material is injected into a disc

Altogether, “Thoracic Discogram” means injecting medication into a disc in the mid-spine to diagnose if it is responsible for the patient’s pain.

Why is a Thoracic Discogram done?

A Thoracic Discogram is performed to get information about the disc, beyond what an imaging study such as an MRI can give. A discogram can tell the doctor if a particular disc is painful or diseased. Also, the doctor can see if the medication injected into the disc has “leaked out” of the disc, which could mean that there is a tear in the outer ring of the disc (annulus). The doctor may also be able to tell if the disc is herniated. Some doctors inject a local anesthetic into the disc in hopes of anesthetizing the disc. This way, the patient may not have disc pain after the procedure which could also verify that the disc was responsible for the patient’s pain.

Often more than one disc is tested to see which disc is responsible for the patient’s symptoms. Also, a normal disc is often tested to know what sensation a patient feels when medication is injected into a disc which should not be painful. This can then be compared to what the patient feels when an abnormal disc is injected.

How is a Thoracic Discogram performed?

Here are the steps of how a Thoracic Discogram is done:

  1. The patient will receive an intravenous (IV) catheter before the procedure. Often antibiotics are given through the IV to prevent an infection. Relaxing medication (sedation) is also commonly given.
  2. The patient is taken to a Procedure Room or Operating Room for the procedure.
  3. The patient is placed on the stomach (prone).
  4. The mid-back is cleaned with a sterile surgical solution and sheets (drapes) are placed to keep the area clean.
  5. The doctor performing the procedure often wears extra protection against infection, such as a surgical mask, gown and gloves.
  6. An X-Ray machine is used extensively for this procedure.
  7. A small amount of local anesthetic is injected under the skin.
  8. A specialized needle (spinal or procedure needle) is placed through the skin and advanced with the help of the X-Ray machine into the disc itself.
  9. At this point, the patient is instructed that medication is about to be injected into the disc. The patient is informed to tell the nurse and doctor exactly what is felt when the medication is injected into the disc.
  10. The medication contains a contrast dye (fluid which looks dark on an X-Ray). Other medications such as antibiotics or local anesthetics are also often included.
  11. The patient’s response to the injection is noted and recorded.
  12. The X-Ray pictures of the contrast dye in the disc are saved. The appearance of the dye in the disc is recorded.
  13. Usually more than one disc is injected to be able to compare the patient’s response to other discs. Often at least one healthy appearing disc is chosen for comparison.
  14. At this point, the needles are withdrawn
  15. Band-aids are placed.
  16. The patient is then taken to a Recovery Area for observation.

How long does it take to complete this procedure?

The procedure can take about 15-30 minutes to complete for each disc level in the spine.

What benefit can patients gain from this procedure?

As a patient, the benefit is mainly that the doctor can get information about the discs in the spine. This procedure is not done to relieve pain from a diseased disc for the longer term, but rather gain information about it. Patients may have pain from the procedure for a period of time afterwards. This will usually get better over the course of several days.