Myelography

(Myelogram)

Definition

Definition

This is an imaging test that uses a special contrast material to view the spinal cord. The contrast material used in the x-ray can help your doctor clearly outline the space containing the spinal cord and nerves.

Reasons for Procedure

Reasons for Procedure

This is used to detect problems in and around the spinal cord, such as:

Possible Complications

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Headache
  • Allergic reaction to the contrast
  • Bleeding
  • Inflamed or infected spinal cord

What to Expect

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam and medical history
  • Ask if you are pregnant—this test is not usually done on women who are pregnant
  • Ask about your medical history
  • Determine if you have any allergies

Leading up to your procedure:

  • The night before, do not eat solid foods after midnight. You should continue to drink liquids.
  • If your doctor prescribes a sedative:

    • Arrange to have someone drive you home. Also, arrange for someone to help you at home.
    • Take the sedative before the exam as directed by your doctor.
  • You may have to stop certain medications up to a week before the procedure.

Anesthesia

There is usually no anesthesia with this procedure. Your doctor may give you a mild sedative. You may have local anesthetic to reduce the pain of the needle.

Description of the Procedure

You will lie on your side or face down. Or, you may sit on the edge of a table, leaning forward. You may be given a local anesthetic injection in your back.

Your doctor will insert a needle into the space between your vertebrae. A small amount of fluid will be removed from the spinal canal. Next, the contrast will be injected through the needle. Your doctor will use an imaging procedure called fluoroscopy. This combines an x-ray unit with a camera and a screen.

To take the images, you will be positioned stomach-down on the table. A brace will be against your shoulders. The table will be tipped forward. Next, the doctor will take images of your back. You will hold your breath while the images are taken. You may be asked to turn slightly to one side and then the other.

Often, your doctor will perform a CT scan after myelography. This is to see the spread of the contrast dye.

Lumbar Myelogram Injection

Copyright © Nucleus Medical Media, Inc.

Immediately After Procedure

You may be asked to stay in the exam room while the doctor looks at the images. You will be able to go home after about an hour.

How Long Will It Take?

About 30-60 minutes (CT scan will take 30-60 minutes longer)

How Much Will It Hurt?

You will have some pressure or pain when the needle is inserted.

Post-procedure Care

  • If you took a sedative, do not drive, operate machinery, or make important decisions until the sedative wears off.
  • Avoid strenuous exercise (including bending over) for 1-2 days.
  • You may be more comfortable lying on your back for 24 hours after the procedure.

Call Your Doctor

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Leakage of fluid from the puncture site
  • Headache lasting more than 24 hours
  • Excessive nausea or vomiting
  • Neck stiffness
  • Numbness in your legs
  • Trouble urinating or moving your bowels
  • Symptoms of allergic reaction, such as hives , itching, nausea, swollen or itchy eyes, tight throat, or difficulty breathing
  • Worsening of your symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

North American Spine Society http://www.spine.org

Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org/patient/public-information.html

Canadian Orthopaedic Foundation http://www.canorth.org/

References:

Lumbar disc herniation. EBSCO DynaMed website. Available at: Available at:
http://www.ebscohost.com/dynamed
Updated November 26, 2014. Accessed December 18, 2014.

Myelography. Radiological Society of North America Radiology Info website. Available at:
http://www.radiologyinfo.org/en/info.cfm?pg=myelography&bhcp=1
Updated June 14, 2013. Accessed December 18, 2014.

Last reviewed December 2014 by Michael Woods, MD
Last Updated: 12/20/2014

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