Annulogram
Live contrast imaging that shows which discs are actually leaking. It finds tears an MRI reports as unremarkable.
Guidance
Fluoroscopy
Performed
Same visit
Answers
Which levels to treat
What the annulogram does
An annulogram answers one question an MRI cannot: which discs are actually leaking. Under live X-ray guidance, a fine needle is placed into each disc in the region being assessed and a small amount of contrast is introduced. In an intact disc the contrast stays contained. In a torn disc it tracks out through the tear — and the leak is visible in real time.
Because every disc in the region is tested, not just the one the MRI report singled out, the annulogram sometimes shows that the disc everyone blamed is intact and the one next to it is the problem. That is the finding that decides treatment.
What it feels like
It is performed on the day of the procedure, under light sedation with local anaesthetic, immediately before the fibrin is placed. Most people describe pressure rather than pain. A torn disc can briefly reproduce familiar pain when contrast enters it — which is itself useful information, and it passes quickly.
Why it decides treatment
Fibrin sealant is placed only into the discs the annulogram shows are leaking. A disc that does not leak is left alone, whatever its appearance on the MRI. This is why the quote you receive before travelling is a starting figure: how many levels are torn is confirmed on the day, and your final figure follows from that.
Common questions
They are related. A traditional discogram pressurises the disc and relies on whether that reproduces your pain. The annulogram as performed here is about imaging the leak itself — where contrast goes once it is in the disc — rather than provoking a response.
Start with the scan you already have.
A physician screens the MRI you already have and tells you in writing whether you appear to be a candidate — before you spend anything, least of all a flight.