Myelogram

What is a myelogram?

A myelogram is used to look at the spinal sac and the nerve roots that exit from the spinal canal. This test uses contrast dye and X-rays and computed tomography (CT) to look for problems in the spinal canal. The doctor will place contrast (X-ray dye) into the spinal sac, through a small needle that he/she inserts into the low back to help determine if there are Problems in the spinal cord, nerve roots, and other tissues. Contrary to MRI, which is for bone or metal visualization and regular CT which is poor for soft tissue problems, the myelogram can help for proper diagnostics of both areas.

How is the procedure performed?

The patient lies on his/her stomach. The skin of the back or neck is cleansed with antiseptic solution and a local anesthetic in injected to numb the area. The skin and deeper tissues are numbed with an anesthetic using a small needle and once the skin is numb, an X-ray machine helps guide the needle into the spinal column space. Once the spinal column is entered, X-ray contrast is injected. The contrast dye appears on an X-ray screen allowing the radiologist to see the spinal cord, subarachnoid space, and other nearby structures more clearly than with standard X-rays of the spine

Will the injection hurt?

There is some discomfort with needle insertion which we minimize by numbing the skin over the joint with a local anesthetic. You may also feel increased pressure in your lower back by the insertion site. You may elect to have a small amount of sedating medication to help with discomfort and to help you relax.

What happens after the injection?

You will be moved into a recovery area and asked to lie down. The bed may be positioned in such a way to have gravity help move the contrast dye to different areas of your spinal cord. You will also be asked to rotate positions. Depending on the location of the spine needing to be reached, you may be in recovery up to 1-2 hours. After this period of time you will be taken back to radiology for CT scans and X-ray imaging. This will produce detailed images of the body.

What is the next step after the injection?

After the test, rest, drink extra fluids to rehydrate after the procedure. This will help to flush out the contrast dye and replace the spinal fluid that was removed. It will also reduce the chance of developing a headache.

What are the risks and side effects?

Because this procedure involves a lumbar puncture, these potential complications may occur: a small amount of CSF can leak from the needle insertion site. This can cause headaches after the procedure. If there is a persistent leak the headache can be severe (sometimes an epidural block patch are utilized if symptoms persist. There is a slight risk of infection because the needle breaks the skin's surface, providing a possible entry point for bacteria. Short-term numbness of the legs or lower back pain may be experienced. There is a risk of bleeding in the spinal canal. If you have kidney problems, discuss and get clearance from your PCP before a myelogram.

• Please ask for an Inspired Spine Logbook if you do not have one in order to keep track of all related information.
• You will need a ride after your injection.
• All blood thinners should be stopped properly before procedure.