Cervical Spine Provocative Discography Discogram neurosurgeon 3D animations

http://www.medilaw.tv Cervical Spine Provocative Discography Discogram neurosurgeon 3D animations. This movie illustrates the technique for performing a cervical provocative discography. This movie shows patient positioning, skin preparation, local anesthetic injection, cannula insertion, contrast injection, simulated CT views of a normal disc, and wound dressing.
Cervical Spine Provocative Discography Discogram neurosurgeon 3D animations.

In a disc herniation, the pain is often caused by the herniation compressing an adjacent structure, such as a nerve or ligament. However, if the disc has an internal wall tear, the blood vessels and nerves of the outer wall can grow into the tear as the body tries to heal the damage. Disc movement or pressure changes can then stimulate these nerves, causing pain.

Provocative discography, also known as disc stimulation, is a procedure in which contrast fluid is injected into the nucleus pulposus of an intervertebral disc to distend the disc. The injected fluid simulates the normal increase in pressure inside the disc that occurs during daily activities. If the area and the quality of your pain are reproduced by the increase in pressure in the disc (known as concordant pain), this suggests that the disc is the source of your pain. The spread of the contrast through the nucleus is also seen on medical imaging scans such as CT or MRI, and can show degeneration or tears within the disc. Often adjacent discs are also injected to determine their likelihood of causing your pain. Sometimes local anesthetic is injected into a disc to assess whether this decreases your pain. Once the source of your pain is identified, then treatment options can be discussed.

INDICATIONS
The indications for provocative discography are
- neck pain which does not improve with conservative treatments
- in clients with abnormalities on CT or MRI, or who are being considered for a pain management or surgical procedure, to assist in identifying the exact location of the pain source
- or clients with pain after neck surgery where MRI is unhelpful in determining the source of the pain.

ALTERNATIVES
The alternative investigations to provocative discography may be
- radiological - X ray, CT scan, MRI scan
- steroid and local anesthetic injections.

INFORMED REFUSAL
It is your right to delay or refuse the recommended investigation for your condition. However, this delay or refusal may increase the difficulty in determining the source of your pain, and the best treatment. You should ask your doctor what might happen should you choose not to undertake the recommended treatment.

BEFORE
Before the provocative discography
- cease blood thinners as instructed ie coumadin/warfarin, plavix, heparin, aspirin
- let your doctor know all the medications you are taking including herbal medications that can increase bleeding risk ie vitamin E, glucosamine, chamomile, danshen, garlic, gingko, devil's claw, ginseng, fish oil, willow bark, feverfew, and goji berries
- you should take your routine medications, but stop any pain relievers or anti-inflammatory medication for the day. You need to have some pain, so you can assess whether the injection gives you any pain relief.
- you will be admitted into the hospital on the day of the procedure
- bring your radiological images and reports ie X-rays, CTs, MRIs
- don't eat or drink for the few hours before the procedure
- wear loose-fitting clothes that are easy to take off and put on. Do not wear any jewelry.
- before the procedure, the skin on your neck will be cleaned and you will be given a general health check. The skin on your neck may be shaved.
- an intra-venous line may be placed into a vein in your arm to administer fluid and medications
- let your doctor know if you develop a fever, cold or flu symptoms before your scheduled procedure. Cervical Spine Provocative Discography Discogram neurosurgeon 3D animations.

GOALS
The goal of a provocative discography is to determine whether irritating the disc reproduces your pain, and hence whether the disc is causing your pain. It will also enable pictures of the shape of the disc nucleus to be taken, which reflect the disc's health.

TECHNIQUE
You will be lying on your back. Your neck will be cleaned. A local anesthetic injection will numb the skin. This may sting for a couple of seconds. A cannula will be introduced into the intervertebral disc. Fluoroscopy, an X-Ray TV, is often used to help guide the cannula to the correct location. Some dye will be injected into the nucleus pulposus. The location and quality of any pain you experience will be recorded. Your doctor may inject local anesthetic into the disc to determine whether this decreases your pain. They may also place antibiotic into the disc space to prevent infection. A CT may be performed for additional information on the condition of the disc.Cervical Spine Provocative Discography Discogram neurosurgeon 3D animations.

Category:

Education

Tags:

• Cervical
• Spine
• Provocative
• Discography
• Discogram
• neurosurgeon
• 3D
• animations