Provocative Discography

What is it?

Provocative discography is an injection technique used as a diagnostic procedure, often when planning surgery for a lumbar fusion. Patients who have continued to experience lower back pain, hip pain, leg pain, or groin pain after extensive conservative treatment (physical therapy, medication, or steroid injections).

What to Expect

Your nurse or physician will conduct an interview during which you can present your concerns, questions, and locations of pain. After choosing to proceed, the doctor will begin an intravenous line. You may not, however, receive sedatives so that your physician can watch for specific reactions during the procedure. The IV line is, instead, for any medications that may need to be dispensed during the surgery. Local anesthesia will be used, and then a smaller needle will be threaded through a larger guide needle to the affected areas.

During the procedure, your physician will ask you to concentrate on the sensations you feel. You may feel nothing, pressure, or pain. Patients will be asked to determine if the pain is familiar (pain you’ve felt before) or unfamiliar (a new sensation of pain that hasn’t been experienced before). The physician will take images with a fluoroscopic unit as each level is pressurized, and then the needles will be removed. CT scans may be ordered by your physician in with this procedure, and must be performed immediately following the discography while the contrast remains in the patient’s system.

After the procedure, you may experience pain from the punctures for several days. Short-term narcotics may be prescribed for this pain, but in many cases, over-the-counter painkillers will be sufficient.

How to Prepare

Because patients will not receive general anesthesia, fasting is not generally required. You may, however, need to cease the use of some medications, especially if they are blood thinners. Discuss your medications with your doctor before your procedure.

A mild sedative may be administered to alleviate anxiety and loosen muscles before the procedure. The sedative isn’t required and may be discouraged to ensure the most accurate results. Talk with your doctor if you’d like to explore relaxation options.

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