Provocative discography is a type of discography that reproduces, i.e. creates, the patient’s “discogenic” pain. The term “discogenic” pain is used when the source of the pain is in the disc itself. This examination is performed on an outpatient basis in our clinic. A local anesthetic is used to numb the surrounding area.
Fluoroscopic navigation is used to guide the needle to the exact disc. Then, the contrast medium is injected into the nucleus of the disc. During this examination, the fluoroscopic monitor checks the exact appearance of the injected agent, as well as abnormalities and damage to the disc.
Also, the patient may experience pains identical to his standard pains due to the pressure caused by the injection of the agent (provocative discography). Discography is indicated when the patient’s symptoms are serious and long-term, regardless of attempts at conservative therapy, when other diagnostic tests (for example, magnetic resonance imaging) do not provide enough information, and when there is a suspicion of an internal disc disorder.
The results of discography are used to confirm a specific diagnosis (e.g. DDD – internal disc disorder).
In our clinic, discography is performed before and during endoscopic procedures on the disc, and sometimes just before laser disc decompression.