I will be arriving at the Southeastern Spine Institue at 2:30pm tomorrow, the 5th of Oct, so that I can be given I.V. sedation before my discogram. I was told that it will be slightly stronger sedation than what I have been given before for the epidural injections but not strong enough for me to be asleep. After the sedation, they will anesthetize a core of tissue that extends from your skin to the disc surface using an injected local anesthetic such as lidocaine. When these tissues are numbed, a guide needle is directed towards the disc and will just touch the outer margins of the disc. Through this guide needle, a much smaller disc needle is advanced towards and eventually inserted into the centre of the disc using fluoroscopic imaging. So here is what happens after I am sedated and they place the needles into the discs:
A contrast agent (dye) is introduced, and after the procedure a CT scan identifies leakage from the discs to identify any disc herniation. I will either; feel nothing, feel pressure or feel pain.
I am to rate the pain produced by the pressurization as 1. familiar pain, which translates into “ouch, that’s my pain!” or 2. unfamiliar pain, which translates into “ouch, I’ve never felt that pain before. This is why I have to be conscious for such a painful procedure, they need my responses in order to get the result of the test.
This will be repeated on discs L3, 4 and 5 without my knowledge of which disc is being pressurized at any given time. This is being done to assess my pain response and make a final decision about which discs to operate on. If the procedure does not cause pain then spinal fusion surgery will not produce any benefit to me. In my case they are definitely performing a disc fusion on L5 since it is so compressed that there is almost no space between vertebrae. L3 is the one that my doctor is almost certain he wants to fuse for 2 reasons, first, it is causing the pain in my L thigh and second if he doesn’t fuse it now he said he would almost definitely have to go back in 10 years or less and do it because of the extra pressure it will take after L5 is done. It has less damage than L5 but is still compressed and has an area that is bulging which is putting pressure on my S1 nerve and causing the pain. Just to be certain though, he wants to do this test first just so he can make sure that surgery is not performed unnecessarily.
Possible complications include discitis, an infection of the disc. Strong antibiotics are sometimes administered as a precaution.
My doctor admitted that this procedure is very painful and I was surprised because most doctors won’t tell you that, they usually say that you “will feel some pressure” and other euphemisms like that but he flat out said that this may “mess me up” for up to 2 weeks which is why I am having it on a Friday and 2 weeks brings me right up to my surgery date of October 19th. I am not going to lie though, I am very scared and I promise I will write up a full report of what it was like for me and post it asap. I am also planning to get my own MRI pics to post on here as well. I think writing about this is helping me deal with the fear, thanks for reading and wish me luck tomorrow, I need it!! Oh and I found out today that my leave from work was approved for 10-18 to 11-30 so that is a big relief, and believe me if I can come back sooner than the 30th of Nov I will, I just wanted to be sure I asked for enough time just in case, so anyway that is one less thing to worry about.