I was told not to drink any fluids or eat any food for 2 hours prior to my procedure. I took this advice seriously as I didn’t want to get nausea or throw up with needles stuck in my Neck.
I arrived at the outpatient scan center, filled out the typical mountain of paperwork and releases. Here sign this… blah blah. Who can really read and understand all that fine print when they are in pain? My advice is to research Discograms BEFORE you have yours so you know what to expect.
After the paperwork shuffle was completed I was seated in the lobby and waited about a half hour until I was called back. I changed into the standard hospital scrubs – a gown that opens in the back and a pair of the pants. I then was taken into the operating theater where I was given an IV.
I received 1gm of an inter venous antibiotic, and placed into position on the table under the fluoroscopic arm. I was also hooked up to a machine to monitor my blood pressure. The Radiologist that did my procedure made sure a full 45 minutes passed before he began (This is a precaution to prevent infection and possible Discitis). During that time he took time to explain to me the procedure and the risks and answered my questions.
My main question was about swallowing during the procedure. Having needles protruding to the center of your cervical spine and swallowing seemed like it was a potential problem, but it’s not. He told me it was okay, but at certain points during the test he would tell me not to. I didn’t know if I would be able to talk with needles in my neck, but it was no problem. I also asked about the gauge of the needles. He told me they would be 25 gauge needles. I had read some Doctors use 22 gauge needles (Lower the gauge the thicker the needle), and sometimes used the 22 gauge to the disc, the slipped a thinner 25 gauge inside the thicker needle. He said there was no reason to do this.
The worst part of the 45 minute ordeal prior to beginning the test was the alcohol based scrub that was pretty powerful! The smell was a bit overwhelming so they placed oxygen in my nostrils to help. They topped off the Alcohol based prep, with another thick yellow gooey prep. And for the record, this is very hard to wash off… you have to just let the last bit wear off after a few showers.
After all the preparation it was time for the Doctor to begin testing my discs. I was given a small amount of Versed (Midazolam) through my IV drip and off we went. The Doctor said he would be testing 4 levels between C4 and C7. For those of you who are new to this the level tested is named after the LOWER Vertebra… so the disc material between C3/4 would be called the C4 disc. You have 7 Cervical Vertebrae but only 2 Discs because C1/2 is a bone in bone joint. Anyways… moving on with the test experience.
The Doctor did not tell me the levels he was testing (So I would not be biased in my responses). And I could not tell what level he was working on. With the first needle puncture he said (This is going to feel like a bee sting… and it kind of did), then he would push the needle in slowly to the disc. He used just enough anesthetic to make the procedure unpleasant, but bearable. When the point of the needle arrived on the edge of the disc, he would tell me then he would push the needle in and tell me as he was injecting.
I should mention that just before each injection I could hear the Fluoroscopic arm move into position. For those of you who don’t know the Fluoroscope takes X-Ray images in rapid succession so the Doctor can see EXACTLY where he is placing the needles.
He asked me to describe the pain on a scale of 1-10, tell him the location of the pain, and if this was typical of my “normal” pain or different from my “normal” pain. Then he would withdraw the needle. At the next level he said “bee sting” and then repeated the process until all 4 levels were complete.
I was told the test would take about half an hour, and that is probably pretty accurate. It’s hard to keep track of time when you have Versad flowing through your veins.
Your personal pain tolerance will no doubt be different than mine. I have had many IV’s and Needle procedures so this was pretty commonplace for me. Yes it hurt! But it is really not much worse than having dental work done (Okay it’s worse then regular dental, but not much worse than a root canal and it takes less time for the actual test than a root canal!). The needles hurt most going in, then only for a few seconds during the active injection of the contrast agent. Not all my discs caused pain… 3 of 4 were painful. Only 2 of 4 above the “5” Threshold on a scale of 1 to 10. What was surprising was the disc that hurt the most was NOT the one I expected to hurt the most. I know this because after the test I asked the Doctor which disc it was that caused the most pain.
Immediately following the completion of the Cervical Discogram I was wheeled into another room and placed in the CT Scanner. I’ve had CT Scans before and they are pretty easy. Because they needed to scan my C6/7 level and I have broad shoulders (Plus my neck was in mild spasm from all the needling) I asked for the straps to help pull my arms down.
The CT Scan was a breeze and only took a few minutes. Unlike MRI’s CT Scanners are basically open so you don’t need to worry if you are claustrophobic. The Downside to CT Scans is RADIATION. And they blast you with a pretty high amount. Be sure to ask your Doctor BEFORE the test about the precautions they use to minimize your exposure. You want the least amount of radiation possible.
After the CT was complete I asked to talk to the Doctor because I had some questions about followup pain and I was pretty sore. He offered to give me an injection of pain medication (I declined because I was pretty much doped up from the Meds I had from the IV). But he did write me a script for a few pills to get me through the next couple of days and told me to be sure to call in to the Scan Center or to my Doctor if I got a fever or felt ill.
I never went to a recovery area, and no one really came to check on me. I waited seated on the side of a bed for about half hour to talk to the Doctor and then got dressed and went home. Total elapsed time start to finish in the Scan Center was about 3 hours.
And while I felt okay, later on that night I was pretty sore. I am about 36 hours post procedure at the time of this writing and pretty close to my normal all day everyday chronic pain self.
Is the risk worth the benefit? Maybe. It depends on your own condition and a whole host of other factors. Most Doctors will not order a Discogram unless they are seriously considering surgery. The point of the test is to correlate Discogenic Pain to your regular pain. If your discs are not causing your pain then surgery may not be a good answer for you. It’s more complicated than that, but that’s the theory anyway. Sometimes the evidence on MRI is so overwhelming that the test is simply not needed. Other times patients have pain that is just not explained until they have the test. Discograms are subjective test, but can be valuable. They are also quite expensive!
That’s it… another test another day.
Cervical Discograms are a Diagnostic Test and do NOT treat pain.
You must be logged in to post a comment Login