What is disc stimulation?
Discal stimulation is a diagnostic procedure performed to determine if a patient’s symptoms are the result of a disc affliction (disc tear, herniated disc). To do so, a needle is inserted in the intervertebral disc under fluoroscopic guidance. Then a contrast medium is injected to increase pressure inside the disc.
The purpose of this procedure is to confirm that a disc is the source (discogenic) of pain by recreating the patient’s usual symptoms. A scan can then be performed to ensure a better discal disease diagnosis. This procedure is indicated when an intra-discal percutaneous (thermal annuloplasty, PRP injection) procedure or surgery is considered after conservative treatment failed on a patient.
This test is performed to confirm a physician’s assumption that a disc is at the source of a patient’s pain, whether an intra-discal tear or a herniated disc.
The procedure is reserved for patients who have not responded to usual conservative treatment, including various types of medication and therapeutic approaches (physiotherapy, osteopathy, massage therapy, etc.) and cortisone injections (epidural). It should not be performed if additional treatment like an intra-discal percutaneaous procedure (thermal annuloplasty, PRP injection) or a surgical procedure is not considered. A scan of the lumbar spine may be performed after disc stimulation for a better view of disc anomalies.
When disc stimulation shows that the pain is due to a disc disease, certain percutaneous (thermal annuloplasty, PRP injection) or surgery procedures may be considered.
The procedure takes about one hour. Patients are settled comfortably on their stomach. When disc stimulation is completed, patients must inform their physiatrist if the pain felt is the usual pain or not.
Save for some cases, the procedure is performed on a minimum of two intervertebral discs, most often three discs. The appropriate position of the injection needle is validated under fluoroscopic control.
In the case of hernia, the pain felt by patients is recreated during the procedure, during which patients work closely with their physiatrist to inform about the site and intensity of the pain and whether the pain stimulated is similar to the chronic pain usually felt.
Pain may increase slightly during the first seven to ten days after injection. If this is the case, applying ice to the treated area and taking acetaminophen helps to ease discomfort.
Risks of intra-discal infection are quite low, since intra-discal antibiotics are injected during this procedure. Allergic reactions to contrast products are extremely rare and can be treated quickly if they occur.
Patients must temporarily stop taking anticoagulants and antiplatelets before the procedure. They must obtain an authorization to do so from their prescribing physician. Disc stimulation during pregnancy is contra-indicated.