Myelogram

What is a Myelogram?

A myelogram is a special x-ray examination to study your spinal canal, spinal cord and the area surrounding it called the subarachnoid space. The procedure involves the injection of contrast material (hyperlink when available) or dye into your spinal canal. This contrast material is an iodinated contrast medium similar to what is injected for a study of the kidneys called an intravenous pyelogram (IVP), and is often injected for CT scans, cardiac catheterizations and angiograms for enhanced visualization.

Note: If you have had a previous allergic reaction to iodinated contrast material, please notify your physician so that the proper steroid preparation can be ordered before your scheduled myelogram.

A myelogram can identify abnormalities of the spinal cord, the spinal canal within which it sits, and the spinal nerve roots connected to it. Myelography is often performed when other exams such as computerized tomography (CT) scans or magnetic resonance imaging (MRI) have not provided enough information for an accurate diagnosis to be made.

How Do I Prepare for a Myelogram?

No food should be eaten two (2) hours prior to your myelogram, but fluids are permitted.

Please let your physicians know about any allergies to food or medications in advance. Also, please notify your physician if you are taking any blood thinning medications such as:

• Aspirin
• Coumadin
• Heparin
• Plavix
• Lovenox

In most cases, such medications will need to be discontinued for a period of time before your procedure according to your physician's instructions.

If you are taking any major tranquilizers, please inform your physician, as some of them may need to be discontinued two days prior to the procedure and restarted one day after the procedure.

Although myelograms are performed on an outpatient basis, we ask that you do NOT drive yourself to the Clinic on the day of your myelogram appointment. Arrangements must be made for someone to drive you TO and FROM your myelogram appointment. Your procedure may be canceled if transportation arrangements are not made in advance.

If you have had MRI or CT films of the spine at another facility, please bring them with you on the day of the myelogram procedure.

What Can I Expect During the Procedure?

When you arrive in the Diagnostic Radiology Department you will be asked to change into a hospital gown, with the opening at the back. At this time you should urinate so you will be comfortable during your myelographic study. Please notify the technologist if you have a history of allergies or seizure disorder. Women in their childbearing years will also be asked about the possibility of pregnancy. If there is any possibility that you may be pregnant, please inform your doctor or the technologist prior to the examination. If you have a fever, call first as it may be necessary to postpone the procedure.

When the examination begins, you will likely be positioned face down on a special x-ray table for the myelographic procedure. This table will be tilted up or down as necessary during the procedure. At different times during the procedure you may be asked to lie on your side or back as well.

Depending on the area to be studied, either your back or neck will be washed with a soapy iodine solution. That area will then be covered by a sterile drape. After injecting a numbing medication (xylocaine) into your neck or back, the radiologist will place a needle into your spinal canal using x-ray guidance, inject the contrast material, and take a series of X-rays of the area in question.

The myelogram procedure takes approximately thirty to sixty minutes to complete, but you can expect to remain in the recovery area for a period of time after your study is finished.

What Can I Expect After my Procedure?

When your myelographic study is complete you will be put on a stretcher in either a semi-upright or flat position. Usually a CT scan will be performed after the myelogram. You will be sent to a recovery area for approximately two (2) hours where a nurse will monitor your progress. You may get up to use the bathroom, but otherwise you should stay in bed and remain on your back for the full two (2) hours. You will be given something to eat and encouraged to drink fluids. Drinking fluids helps eliminate the possibility of side effects, such as headaches, nausea and vomiting. If a headache, backache, or nausea should occur while you are in the recovery area, let the nurse know immediately. Medications are available to help make you more comfortable.

Your physician may discuss the results of your myelogram with you while you are in the recovery area and will discharge you at the appropriate time. Most people go home after their brief stay in the recovery area, but if you are not feeling well, your physician may elect to keep you overnight. When your doctor discharges you from the recovery area, please follow the instructions that will be given to you by the nurse.

Prior to the date of your procedure, your Lahey Health Care Provider will discuss with you what you can expect before, during and after your myelogram study, and answer your questions.