Myelogram

What is a myelogram?

A myelogram is an invasive diagnostic test that uses X-rays to examine the spinal canal of a patient who cannot receive an MRI due to medical implants or other reasons. Contrast is injected into the spinal canal through a hollow needle. An x-ray fluoroscope then records the images formed by the contrast. Myelograms can show conditions affecting the spinal cord and nerves within the spinal canal.

What preparation is needed?

  • Drink as much fluid as possible up to 3 hours before the examination.

  • You might be admitted before the hospital examination to be under observation for at least 24 hours after the procedure. Otherwise, you will spend at least 4 hours in the department after the examination for observation.

  • You cannot drive yourself home; please arrange for someone to take you home.

  • Mild sedation can be arranged if you are anxious.

What are the possible complications?

  • Infection (meningitis, encephalitis or local abscess)

  • Post-lumbar puncture headache (PLPH)

  • Nerve injury

What happens during the examination?

The radiographer will describe the procedure on your arrival, including the risks and possible complications. The radiographer will answer all the relevant questions you might have. You need to sign a consent form before the examination.

You will be asked to undress everything (except underwear) and put on a gown with an open end to the back. Then, you will be positioned on the X-ray table. A myelogram is a sterile procedure, so it is essential not to move as soon as it starts. The radiologist will clean your back with a cold antiseptic, and then local anaesthesia will be injected to numb the area where the needle will be inserted. This may cause some brief stinging.

Next, a slender, hollow needle is inserted into your spinal canal to draw out some cerebrospinal fluid for testing. The contrast is inserted into the spinal canal through the hollow needle. You will probably only feel pressure, though some people feel a sharp stinging sensation. After the contrast is injected, you lie on your stomach with a pillow under your abdomen. The table may be tilted to move the contrast dye through your spinal canal, and x-ray pictures of your back will be taken. At this point, you should remain very still so that the X-ray images will not be blurred. Routinely, a CT scan will be done after 1 hour.

What happens after the procedure?

After the x-rays and CT scans, you will be taken back to the ward or observed for four hours in the department. You should lie down with your head raised. Once you are discharged, a friend or family member may drive you home. Drink lots of fluids.

What about the result?

Once the examination is complete, the radiologist will compare the X-rays to any previous imaging of the same area.  A typed report of the findings will be forwarded to your doctor.  Please contact your doctor for the results.