These studies are performed with a machine called a fluoroscope. This is a device that has a tilting table connected to an x-ray machine and a television screen. The fluoroscope produces a real-time x-ray image of you on the TV screen while you are on the table. The images on the screen can then be turned into permanent images, which are used for diagnosis.
Many fluoroscopic procedures use a liquid contrast (dye). This liquid comes in different forms, which make it much easier for x-rays to show internal parts of the body such as the stomach, esophagus, or colon. Images are taken on the fluoroscope as the contrast material passes through these parts of your body. A trained and experienced radiologist will interpret the study. Specific studies are listed below.
A myelogram uses a special dye and an x-ray (fluoroscopy) to make pictures of the bones and the space (subarachnoid space) between the bones in your spine (spinal canal). A myelogram may be done to find a tumor, an infection, problems with the spine such as a herniated disc, or arthritis.
The spinal canal holds the spinal cord, spinal nerve roots, and a fluid-filled space called the subarachnoid space. A dye is put into the subarachnoid space with a thin needle. The dye moves through the subarachnoid space so the nerve roots and spinal cord can be seen more clearly. Pictures may be taken before and after the dye is used. A myelogram may also be done with a CT scan. A radiologist will perform the test in the Special Procedures suite of the Radiology department at our outpatient-imaging center
How should I prepare for the test?
There are certain medications, including but not limited to, aspirin, blood thinners such as warfarin (Coumadin) and clopidogrel bisulfate (Plavix), antidepressants, and Glucophage for diabetes that may interfere with the dye used in the test. You will need to discontinue these medications 72 hours prior to the date of the test. You should contact your doctor’s office when your appointment is scheduled to discuss your medications. Please alert us if you are allergic to iodine. They will give you specific instructions for taking your medications on the day of the myelogram.
- Drink as much fluid as possible up to midnight the day before your myelogram.
- You must arrive 1 hour and 15 minutes prior to your appointment.
- DO NOT EAT ANYTHING AFTER MIDNIGHT or 6 hours prior to your exam time. (Diabetics may have different instructions.)
- Make arrangements to have someone to drive you to and from the outpatient center. You will not be able to drive yourself home. Recovery time can take up to 4 hours.
What happens during the test?
Step 1. Prepare the patient
You may be given a sedative to make you drowsy and relaxed. A doctor and at least one technician will be in the room. You will lie on your stomach with a pillow beneath it. After cleaning your back with a cooling antiseptic, the doctor will numb the area of your back where the needle will be inserted. This may cause some brief stinging.
Step 2. Insert the needle into the spinal canal
Next; a slender, hollow needle is inserted into your spinal canal to draw out some fluid (cerebrospinal fluid) for testing. The contrast dye is inserted into the spinal canal through this hollow needle. You will probably only feel pressure, though some people feel a sharp stinging sensation. Let the doctor know if you are feeling pain.
Step 3. Take X-ray pictures
After the dye is injected you will lay 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 will be taken of your back. At this point you should remain very still so that the x-ray images will not be blurred. Most patients will have a CT scan following the myelogram.
What Happens After the Test?
After the x-rays and CT scans have been taken, you will be taken back to a room and observed for approx 4 hours with your head raised. Once the doctor releases you, a friend or family member may drive you home.
Sedation and Pain Management
At Austin Radiological Association, we are able to provide sedation and pain management services that make imaging exams more comfortable for people who are claustrophobic or need pain medication in order to remain still for the exam. We can also provide sedation for children who require medical imaging and would otherwise be unable to remain still for an exam. Our registered nurses and paramedics have the training and experience necessary to make your exam, or your child’s exam, a safe and comfortable experience. Below is an overview of our services.
Types of Sedation
We employ two different types, or levels, of sedation:
Light Sedation: This is the administration of medications, usually pills that are swallowed, for the reduction of anxiety. In this stage of sedation, you will be awake, but relaxed. You will have slightly slowed movements, have normal respirations, normal eye movement and intact protective reflexes. This is not anesthesia, and you will not require assisted breathing in this type of sedation.
Conscious Sedation: This is a medically controlled state of depressed consciousness. It can be produced with pills, but is more commonly produced with an injection of medication. In this stage of sedation, you will be sleepy, and have more noticeably slowed movements, but you can still respond when someone speaks to you. You are also able to maintain intact protective reflexes. This is not anesthesia, and you will not require assisted breathing in this type of sedation.
- Arthrography with plain x-ray, CT, or MRI
- Barium enema – single contrast, or air contrast, or Gastrografin
- Barium swallow
- Upper GI
- Conventional tomography
- Routine x-rays or radiographs
- Small bowel follow through
- Voiding cystourethrogram
- Pediatric fluoroscopy