What is an Intervertebral Disc
The intervertebral disc is a fibrocartilaginous structure found between the bodies of adjacent vertebra. There is a disc between each pair of vertebra in the spine except at the first and second cervical level.
It has a series of outer fibrous rings surrounding a softer center. The disc functions as a cushion, allows for movement and serves as a cartilaginous joint between adjacent vertebrae.
When you think and try to picture this disc, think of a jelly doughnut.There are 4 parts: the soft, “nucleus pulposus” in the middle, a series of outer fibrous rings called the “annulus fibrosis” surrounding the nucleus, and 2 end plates that are attached to the adjacent vertebral bodies. These discs serve as a cushion or force dissipater, transmitting compressive loads throughout a range of motion. The disc also allows movement while serving as a cartilaginous joint between the vertebrae. The disks are thicker anteriorly and therefore contribute to normal cervical and lumbar lordosis.
With age or injury, the wall of the spinal discs can wear-out, or be damaged. This condition is called degenerative disc disease. Also, the walls of the discs can weaken bulge out or tear occasionally – enough to cause a herniated disc. When the disc itself causes pain, the pain is usually felt as a deep, aching pain in the neck or back. Neck discs may sometimes lead to pain felt in the arms and upper back. Back discs may sometimes cause pain into the buttocks and into the thighs. However, pain from other structures in and around the spine may cause pain in the same locations and feel the same.
Discography is currently used to determine whether a vertebral disc is the source of pain in patients back or neck. A disco-gram can be done at several levels and is a diagnostic tool not a treatment.
This outpatient procedure is the targeted placement of a saline and contrast solution into one or multiple discs in the spine. The purpose of this procedure is to determine if a disc is the exact source of your pain. Identifying the exact source of pain may lead to a minimally invasive disc procedure. Once the procedure is completed, a CT scan is performed to visualize the solution inside the disc, which may show tears and scarring as well as herniation. It can be performed in the cervical, thoracic or lumbar regions. All procedures are done under fluoroscopic guidance (X-ray guided) to ensure proper placement of the medication and may be performed in an ambulatory surgical center, fluoroscopy suite or hospital setting.