Myelogram

A diagnostic fluoroscopic study of the spinal canal, nerve roots and spinal cord by injection of contrast solution into the spinal canal. A myelogram may be used to determine the cause of arm or leg numbness, weakness or pain. It looks for narrowing of the spinal canal, spinal stenosis, spinal tumors, herniated discs, and inflammation of the membrane surrounding the spinal cord.

What is a Myelogram? Who Performs the Exam?

A myelogram is a radiologic examination of the spinal cord and the space surrounding it. A contrast medium (commonly called "dye") will be injected into your spinal canal. The contrast medium highlights the area of interest. A radiologist performs the examination. A radiologist is a medical doctor who specializes in the use of X-rays for diagnosis of medical conditions. The radiologist is assisted by a radiologic technologist, who is trained in the use of X-ray equipment.

Where is the Exam Performed? How Long Does the Exam Take?

Myelograms are performed at Mid-Delaware Imaging. Your exam probably will be completed in approximately 2 hours, but may take longer. The recovery period is about 1-2 hours. Plan to be at MDI for 1-3 hours. Arrange to have someone drive you home. In addition, plan on having someone stay with you for 24 hours following the procedure.

What Happens During the Exam?

There are various techniques used for administering the contrast medium. Usually, you lie on your stomach on the X-ray table. The radiologist will view your spine on a TV monitor to identify the best location to insert the needle. First, the area will be cleaned with antiseptic solution, which may feel a little cold. Second, you will feel a pin prick in the skin, and a brief burning sensation as a local anesthetic is injected. The radiologist will insert a needle and inject the contrast medium. The X-ray table will be tilted slowly to allow the contrast medium to travel to different levels of the spinal column. The radiologist will watch the flow of the contrast medium on a TV monitor. Then the technologist will take a series of X-rays while the table is tilted in various positions. You will then be taken to another room where a CT scan of the spine will be performed.

Myelogram Exam Instructions

Exam Preparations

  • If you are a smoker, please stop smoking the day before your test and on the day of your test. Smoking before the procedure may contribute to headaches or nausea after the procedure.
  • It is important to stay well hydrated until the time of your exam. For this reason, we recommend that you drink 4-8 ounces of fluids every 2 hours while you are awake. This regimen may start at noon the day before your test and continue until 6 hours before your exam. You may drink clear liquids up to 2 hours prior to the procedure. Examples of clear liquids include water, tea, apple juice, carbonated beverages (soda pop), black coffee, sugar water, Hawaiian Punch. These liquids should not include alcohol. Orange juice is NOT a clear liquid.
  • No food after midnight the night before this procedure. Only clear fluids should be consumed as above. If your test is scheduled after noon, you may eat a small breakfast followed by fluids leading up to the exam. Please do not each lunch.
  • If you are taking any of the following drugs, you should stop taking them 2 days before your myelogram and resume taking them 2 days after your myelogram. Before stopping these medications, please speak with your doctor.
    A) Certain antipsychotic medications, especially Phenothiazines. For example Thorazine,Compazine and Torecan.
    B) Certain antidepressants, such as Amitriptylines - for example, Elavil, Endep
    C) MAO Inhibitors, such as Parnate, Nardil, Marplan
    D) Ultram derivatives
  • Blood thinners, like Coumadin and Lovenox, need to be stopped prior to your procedure. You must ask your physician for instructions regarding the length of time. If you take aspirin, please stop the medication for 5 days before your procedure.
  • Allergies: If you are allergic to contrast (X-ray dye) or iodine, let your doctor know as soon as possible. Let the radiologist know about your allergy a few days before your scheduled myelogram.
  • Please bring any imaging studies you may have at home with you to MDI when you come for your procedure. These include MRI's, CT scans and plain spine x-rays.
  • If you are a woman of childbearing age, you will be asked if you could be pregnant. If there is any chance that you may be pregnant, please obtain a pregnancy test through your doctor before this procedure.
  • If you have any questions regarding medication, contact MDI at 302-734-9888.

Before Your Exam

  • Please arrive 30 minutes prior to your exam time.
  • With approval from your doctor or provider, discontinue use of blood thinners such as Coumadin, Heparin, Lovenox or aspirin three days prior to your exam.
  • Arrange for a family member or friend to accompany you. We require you to have a driver before being discharged.
  • Jewelry, including piercings, must be removed prior to your study. Patients are encouraged to leave all jewelry at home.
  • Do not eat 4 hours prior to exam; take clear liquids only. Continue medications as prescribed except for blood thinners as noted above.
  • Wear comfortable two-piece clothing.

For your safety, please notify our scheduling department and technologists:

  • If you are allergic to CT scan/X-ray contrast (dye)
  • If you have a history of seizures or headaches
  • If you believe you may be pregnant

Patient Experience

Our technologists are specially trained and certified by the American Registry of Radiological Technologists. During the study, you will lie on a motorized X-ray table that can be tilted up or down. You will lie on your stomach and your back will be marked with a pen where the puncture will occur. The area will be sterilized and numbed with lidocaine. The sterilizing solution may feel cool or cold. Once the needle is in place, the radiologist will inject the contrast solution and take X-rays. After the myelogram, you will receive a CT scan to get more detailed cross-sectional and 3-dimensional images of your spine, which will be used in conjunction with the X-rays. After the procedure, you can expect to remain in the X-ray department for up to one hour to minimize the chance of having a headache and to give your body a chance to rest and recuperate.

After The Exam

Once the exam is completed, the images are analyzed by a board certified radiologist who generates a diagnostic report outlining the findings. This report is then sent to your physician within 24 hours. Your physician will consider the radiologist's interpretation of your scan in the context of your overall care.

  • Have a responsible adult drive you home and remain with you for the rest of the day. No activity during the first 48 hours after myelography. Stay in bed/or on the couch as much as possible. When lying down, keep your head raised at least 45 degrees, as if you are reclining in a lounge chair. Do not allow your head to go below the level of your chest, as in bending over to pick up an object off the floor. During the 48 hour recovery phase you will need to avoid any activities that would cause you to bear down or to strain.
  • No solid food for two hours, then resume usual diet. During the 48 hr recovery phase you need to increase your caffeine intake by sipping caffeinated beverages during all waking hours. Drink plenty of fluids. This helps your kidneys eliminate the contrast from your body faster. Avoid alcoholic beverages.
  • You may resume all medications after the procedure with the exception of Metformin medication for diabetes and blood thinners. Metformin medication may be resumed after 48 hours only after your kidney function has been checked.
  • If headache, nausea, or vomiting should occur following the myelogram, it will likely mimic the flu in duration and severity. If the headache is severe and is not relieved by reclining with your head at a 45 degree angle or with Tylenol/Ibuprofen, or does not go away after 24 hours, you may be experiencing a spinal headache. This may be caused by the reaction you may have to the dye or the actual puncture made by the needle in the spine, or by not following the discharge instructions. In this case, continue to recline with you head raised at least 45 degrees and contact us at 302.734.9888, Monday�Friday, 8:00 a.m. to 5:00 p.m. If it is after hours, please contact your doctor or go to the emergency room.

Further Information

If you would like additional information on this procedure, we recommend visiting the Myelogram section of RadiologyInfo.org.

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