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.