Myelogram

What is a myelogram?

A myelogram is a type of X-ray of the spinal cord and of the space around it (called the subarachnoid space). A dye that can be seen with X-rays is injected into this space. The dye outlines the spinal cord so that it can be seen on the X-ray. A myelogram provides a detailed picture of this area.

When is it used?

A myelogram tests for the following:

• blockage of the flow of spinal fluid
• herniated (slipped) disc in the back
• bone spurs (spinal arthritis)
• tumors or other growths in the spine or spinal cord
• ruptured disks in the back
• infection
• blood vessel problems
• suspected problems at the base of the brain.

CT scans (computed tomography) and magnetic resonance imaging (MRI) have replaced this procedure for many uses. New imaging techniques let your provider see nerves and growths directly. Before these new techniques were developed, only the dye surrounding the nerve or abnormal growth could be seen.

How do I prepare for a myelogram?

• Give the person doing the test a list of your medicines. You will have to stop taking certain medicines 1 to 2 days before the test, such as:
  • antidepressants
  • blood thinners
  • antipsychotics
  • diabetes medicines (especially metformin)
  • antibiotics.
• Be sure to drink lots of fluids during the 24 hours before the test.
  • Do not eat solid foods for 8 hours before the test.
  • Empty your bladder and bowel before the test. Sometimes your healthcare provider will want you to take a laxative or an enema.
• Remove any jewelry near the area of your body being studied.
• Follow any other instructions your provider gives you.

What happens during the procedure?

Your provider will inject the dye at the base of your spine. You will feel a brief sting when this happens. You will lie face down on a tilting table under a fluoroscope. This device takes moving X-ray images. Tilting of the table allows control of the flow of the dye in your body. Fluid may be taken out of your spine for lab tests.

The procedure takes 30 to 60 minutes. Sometimes a CT scan is done after the myelogram. This test is then called a CT myelogram.

What happens after the procedure?

• Depending on where you have the test done, you may stay in a recovery room for up to 4 hours.
• After the test, you will be instructed to keep your head elevated and to avoid bending over. Someone will need to drive you home.
• Drink lots of fluid after the test. It helps your body get rid of the dye.
• Do not do any strenuous exercise for 1 to 2 days after the test.

What are the benefits of this procedure?

The benefits of this procedure are:

• A myelogram can be combined with CT or MRI to give an even more detailed image.
• Sometimes if a CT scan or MRI does not show any problems, a myelogram can show the cause of pain.
• The myelogram may be able to show if surgery might be helpful.

What are the risks of this procedure?

Possible risks include:

• You may have an allergic reaction to the contrast dye.
• If you are dehydrated (have not drunk enough fluids) or your kidneys do not work well, your kidneys may stop working (kidney failure).
• In rare cases the needle used to inject the dye can cause a nerve injury
• The membrane covering the spinal cord may become irritated.
• You may get a headache.
• You may get an infection.

If you are or may be pregnant, you need to tell your healthcare provider. The X-ray may harm the baby.

When should I call my healthcare provider?

Call your provider right away if you:

• Have a fever over 100.4 degrees F (38 degrees C).
• Have severe nausea or vomiting.
• Develop severe headaches that last more than 24 hours.
• Have numbness in your legs or stiffness in your neck.
• Have problems urinating or having a bowel movement.